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Chapter 21 Agents Used in the Treatment of Hyperlipidemia.

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Presentation on theme: "Chapter 21 Agents Used in the Treatment of Hyperlipidemia."— Presentation transcript:

1 Chapter 21 Agents Used in the Treatment of Hyperlipidemia

2 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved Hyperlipidemia Fats in the blood  Chylomicrons  VLDL = very low-density lipoproteins  LDL = low-density lipoproteins  HDL = high-density lipoproteins

3 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved Agents Used to Treat Hyperlipidemia Drugs used to lower lipid levels

4 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved Hyperlipidemics Prevent heart disease According to Ignatavicius and Workman, Medical-Surgical Nursing: Critical Thinking for Collaborative Care, 2005, the risk for coronary heart disease is three times greater if the cholesterol level is at or above 260 mg/dL compared to a person with a level of 200 mg/dL or lower.

5 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved Classification of Hyperlipidemics Fibric acid derivatives HMG-CoA reductase inhibitors (HMGs or statins) Niacin (nicotinic acid) Bile acid sequestrants

6 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved Fibric Acid Derivatives Reduce the synthesis of triglycerides in the liver  Decrease VLDL and LDL  Increase HDL Side effects  Nausea, flatulence, bloating, diarrhea, and liver changes

7 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved HMG-CoA Reductase Inhibitors Inhibit HMG-CoA reductase  Enzyme used by the liver to produce cholesterol  Lowers the rate of cholesterol production Side effects  Liver changes  GI upset, constipation, or diarrhea Atorvastatin is very effective.

8 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved Vitamin B 3 Niacin Requires higher doses than when used as a vitamin  Decreases triglycerides  Increases HDL  Effective and inexpensive  Often used in combination with other lipid- lowering agents Side effect  Hypotension from vasodilation

9 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved Bile Acid Sequestrants Bile acids are necessary for absorption of cholesterol Mechanism of action  Combine with bile acids  Form insoluble complex  Result Prevent resorption of bile acids from small intestine

10 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved Bile Acid Sequestrants: Therapeutic Uses Treatment of hyperlipidemia  Decrease the triglyceride levels  Increase HDL by as much as 25%

11 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved Side Effects of Hyperlipidemics Abdominal discomfort Diarrhea or constipation Nausea Headache Increased risk of gallstones Prolonged prothrombin time Liver studies: dysfunctional changes, elevated enzymes

12 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved Hyperlipidemics All hyperlipidemic agents  Take several weeks to show effectiveness

13 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved Nursing Implications Contraindications  Biliary obstruction and active liver disease  Liver function studies Long-term therapy  Requires supplemental fat-soluble vitamins (A, D, E, and K) Take with meals to decrease GI upset. (continues)

14 Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved Nursing Implications Obtain a thorough health and medication history Assess dietary patterns, exercise level, height and weight, vital signs, and family history (genetics, and tobacco and alcohol use) (continued)


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