PHARMACOLOGY

TERM 3

Topic Outline:
● ANTIHYPERLIPIDEMIC DRUGS

Lipid Lowering Agent (Antihyperlipidemic Drugs)

Goal: ↓lipids in the blood
→ prone to plaque build-up
→ limited blood supply
→ limit O2 supply
ANTIHYPERLIPIDEMIC DRUGS
• Antihyperlipidemic drugs are medications used to lower
elevated levels of lipids (fats) in the blood, particularly
cholesterol and triglycerides.
Bad (LDL)
• High levels of these lipids can increase the risk of
- stores/cholesterol in the bloodstream
cardiovascular diseases, such as heart attacks and
Good (HDL)
strokes.
- regulates LDL storage and promotes excretion
• Antihyperlipidemic drugs are an essential part of
managing conditions like hyperlipidemia/high lipid levels)
Drugs that Lower Serum LDL levels
and dyslipidemia (abnormal lipid levels).
1.Bile Acid Sequestrants
NOTES:
2.HMG-CoA Reductase Inhibitors
Heart Attack
3. Cholesterol Absorption Inhibitor
- plaque build up that totally obstruct the BV
- No BS in vital organs Acid Sequestrants
Brain cholesterol - Ingredient → Liver- Bite Acids
Stroke (CVA) • Bile acid sequestrants work by binding with bile acids in
- plaque build up in the arteries (brain) the intestine, preventing their reabsorption.
- ↓BS in the brain • This forces the liver to use cholesterol to produce more
- S/sx: altered LOC → CONFUSION bile acids, which in turn lowers the level of LDL
HYPERLIPIDEMIA cholesterol in the blood.
• Significant risk factor for the development ↓ Bile acids - help digest fats & absorb fat-soluble
of/cardiovascular diseases, such as coronary artery vitamins
disease, heart attacks, and strokes Drugs include:
• To prevent hyperlipidemia • Cholestyramine (Questran)
• Healthy diet - ↓fats, fast food, deep fried foods • Colesevelam (Colestid)
• Limit alcohol • Colestipol (Welchol)
• Physical activity→ the more you move, the more fats Contraindications:
can be digested • Allergy to bile acid sequestrants
• Smoking cessation • Biliary obstruction - prevent bile from being secreted
• Lifestyle modifications into the intestines
• Use of medications • Abnormal intestinal function - aggravated by the
NOTES: presence of bile acid sequestrants
Arteriosclerosis→ Hardening of the arteries • Pregnancy and lactation - decrease in absorption of fat
Atherosclerosis→ Narrowing of the blood vessels
and fat
-soluble vitamins can be detrimental to fetus or neonate
Side effects:

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• Common side effects include Gl symptoms such as: • Rhabdomyolysis (rare but serious) - breaking down of
constipation, bloating, gas, and abdominal discomfort muscles

NURSING RESPONSIBILITIES NURSING CONSIDERATIONS

• Emphasize the importance of taking the medication • Monitor Liver Function:
with meals and following dietary recommendations. - Regular Tests: Check liver function tests (LFTs)
• Advise on the potential for constipation and strategies before starting treatment and periodically during
to manage it (e.g., increasing fiber intake, fluids). therapy, as statins can affect liver enzymes.
• Educate patients on the importance of a - Signs of Hepatotoxicity: Watch for symptoms like
low-cholesterol and high-fiber diet to enhance the jaundice, dark urine, or abdominal pain.
effectiveness. • Assess for Muscle Symptoms:
• Educate about the potential need for vitamin - Myopathy: Be vigilant for signs of muscle pain,
supplementation. tenderness, or weakness, which could indicate
Be aware of interactions with other medications and myopathy or rhabdomyolysis, a rare but serious
advise patients to take other medications at least 1 side effect.
hour before or 4-6 hours after the bile acid - Creatine Kinase Levels: Monitor creatine kinase
sequestrant. (CK) levels if muscle symptoms occur.
• Monitor lipid levels to assess efficacy. • Educate on Medication Adherence:
Ensure the patient understands the proper way to take - Consistency: Emphasize the importance of
the medication, often mixed with water or other taking the medication as prescribed, even if the
non-carbonated liquids to minimize gastrointestinal patient feels well.
side effects. - Timing: Some statins are given at night (e.g.,
• Avoid in patients with a history of bowel obstruction, simvastatin), as cholesterol synthesis
as bile acid sequestrants can worsen the predominantly occurs at night
• Watch for Drug Interactions:
HMG-COA Reductase Inhibitors (statins) - Grapefruit Juice: Advise patients to avoid
• Statins work by inhibiting an enzyme called HMG-CoA grapefruit juice, which can increase statin levels
reductase, which is involved in the production of and risk of side effects.
cholesterol in the liver. By blocking this enzyme, statins Cholesterol Absorption Inhibitors
reduce the synthesis of cholesterol, leading to lower • Used to lower cholesterol levels in the blood by
levels of LDL cholesterol in the bloodstream. reducing the absorption of dietary cholesterol from the
Drugs include: intestines.
• Atorvastatin (Lipitor) • These drugs primarily target the absorption of
• Fluvastatin (Lescol) cholesterol in the small intestine, blocking the absorption
• Lovastatin (Mevacor) of cholesterol.
• Pitavastatin (Livalo) • Drug include:
• Pravastatin (Pravanchol) • Ezetimibe (Zetia)
• Simvastatin (Zocor)
Contraindications:
Contraindications: • Allergy to the drug
• Allergy to the drug • Liver disease
• Active liver disease - exacerbated by drug's therapeutic • Pregnancy and lactation
effect and has the potential to lead to severe liver Side effects:
failure • Mild Gl symptoms such as diarrhea or abdominal pain
• Pregnancy & Lactation - potential for drug adverse NURSING RESPONSIBILITIES
effects to fetus or neonate •Monitor Liver Function: Regularly check liver enzymes.
• Impaired endocrine function •Assess for Side Effects: Watch for gastrointestinal
• Renal impairment issues and muscle pain.
Side effects: •Monitor Lipid Levels: Track cholesterol levels to assess
• Muscle pain effectiveness.
• Digestive symptoms • Advise on Lifestyle: Encourage heart-healthy diet and
exercise.
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