Which statement will indicate that the patient understands the discharge instructions regarding cholestyramine (QUESTRAN)

I will increase fiber in my diet

Cholestyramine can cause constipation; thus increasing diet is appropriate.

The nurse plans which of the following interventions to decrease the flushing reaction of niacin

Administer ASA 30 mins. before nicotinic acid

Administration of an antiflammatory drug such as ASA has been seen to decrease the flusing reaction associate with niacin

HMG-CoA inhibitors (STATINS) are generally administered at which time

In the evening

The liver produces the majority of cholesterol during the night.  Thus statin drugs, which work to decrease this synthesis, are generally administered during the evening so that blood levels are highest

Which are common side effects of fenofibrate (TRICOR) a fibric acid derivative

Nausea, Vomitting, and Adbdominal Pain

Increase in gallstone formation

Impotence

Diarrhea, not constipation is a common side effect of fibric acid derivatives

Discharge teaching for a patient receiving an antilipemic medication would include

Continue your exercise program, and maintain a diet high in omega-3 fatty acids

The therapeutic regimen used to decrease serum cholesterol

What is the mechanism of action of ezetimibe (ZETIA)

Inhibiting absorption of dietary and biliary cholesterol in the small intestine

Ezetimibe is the newest type of antilipemic medication, working by inhibiting the absorption of cholesterol in the small intestine

Cholestyramine (QUESTRAN) decreases lipid levels by

Binding to bile in the intestional tract, forming an insoluble complex that is excreted in the feces.

Cholestyramine is an anion exchange resin that binds to bile to form an insoluble complex that is excreted.  The liver must then use cholesterol to synthesize more bile.

Which statement made by the patient demonstrates knowledge deficit regarding colestipol (COLESTID)

I should mix and stir the powder in as small amount offluid as possible in order to maintain potency of medication.

Colestipol is a powder that must be well diluted in fluids before administration to avoid esophageal irritation or obstruction.

Atrivastation (LIPITOR) decreases lipid levels by

Inhibiting HMG-CoA reductase, the enzyme responsible for the biosynthesis of cholesterol in the liver

Atorvastatin (LIPITOR) is an HMG-CoA inhibitor, decreasing the sythesis of cholesterol in the liver

Which test will the nurse use to assess for adverse reactions to HMG-CoA reductase inhibitors

Liver Function Tests

HMG-CoA reductase inhibitors can cause hepatic toxicity thus it is necessary to monitor liver function tests every 3 months for the first year

Discharge teaching for a patient receiving simvastatin (ZOCOR) should include the importance of reporting which symptoms that might indicate a serious adverse reaction to the medications

Muscle pain

Muescle pain must be reported because it could signfy an uncommon but serious side effect of rhabdomyolysis associated with statin drugs

The nurse would question an order for simvastatin (ZOCOR) in a patient with which condition

Hepatic DX.

Simvastatin (ZOCOR) can cause an increase in liver enzymes and thus should not be used in patients with preexisiting liver dx.

A patient with elevated triglyceride levels unresponsive to HMG-CoA reductase inhibitors will most likely be prescibed which drug

gemfibrozil (LOPID)

Gemfibrozil, a fibric acid derivative promotes catabolism of triglyceride-rich lipoproteins

The nurse would question an order for colesvelam (WELCHOL) in a patient with which condition

Complete Bowel Obstruction

Coleseval (WELCHOL) binds with bile in the intestinal tract to form an insoluble complex.  It can also bind to other substances and lead to intestinal obstruction

The nurse will assess a patient receiving gemfibrozil (LOPID) and warfarin (COUMADIN) for which adverse effect

Increased risk of bleeding

Gemfibrozil can bind with vitamin K in the intestinal tract, vitamin K absorption