Pharmacology, part 14: Cardiovascular Medications for Cholesterol

by Cathy Parkes 1 Comment

In this video

Statins (atorvastatin, simvastatin)

  • Used for
  • Mode of action
  • Side effects
  • Administration
  • Tip to remember
  • What to monitor

Cholesterol absorption inhibitor (ezetimibe)

  • Mode of action
  • Tip to remember
  • Side effects
  • What to monitor

Bile acid sequestrants (colesevelam, cholestyramine)

  • Used for
  • Mode of action
  • Side effects
  • Tip to remember
  • Administration
  • Drug interactions

Antilipemic medications (gemfibrozil, fenofibrate)

  • Tip to remember
  • Used for
  • Mode of action
  • Side effects
  • Patient teaching

Niacin

  • Used for
  • Side effects
  • What to monitor

Full transcript

Okay, in this video, we are going to cover cholesterol medications, or antilipemic medications if you're feeling fancy.

The first class we're going to talk about are statins.

So statin medications are used for hypercholesterolemia. They are also used for prevention of coronary heart disease in patients who are at high risk.

So statins, their mode of action is to decrease LDLs which are the bad cholesterol. So L for lousy. They also increase production of HDLs which is the good cholesterol. So H for happy.

Side effects for statins are going to be very important for you to remember. So that includes hepatotoxicity, muscle pain, rhabdomyolysis, as well as GI upset.

In terms of administration, you're going to advise your patient to take this medication with their evening meal because cholesterol is synthesized at night.

So the tip I got from one of our crew members is that statin kind of looks like satin. So you take your statin right before you crawl into your satin sheets at night. And it just helps you to remember when this type of medication is administered.

Also during therapy, you're going to want to closely monitor your patient's liver function because of that risk of hepatotoxicity. You're also going to want to monitor their creatine kinase levels because of the risk of rhabdomyolysis.

And then lastly, you want to advise your patient to avoid alcohol and avoid grapefruit juice while taking their statin.

Next let's talk about a cholesterol absorption inhibitor, which is ezetimibe.

Ezetimibe works to prevent hypercholesterolemia by inhibiting the absorption of cholesterol in the small intestine.

So my tip for you is that ezetimibe will help cholesterol zip through the small intestine and not get absorbed.

Key side effects with this medication include hepatotoxicity as well as muscle pain. So again, this was like the same side effects we had with the statins, and you'll see that it's going to be kind of consistent across these cholesterol medications.

So while the patient is taking ezetimibe, you want to closely monitor their liver function as well as their CK levels.

Now let's talk about our bile acid sequestrants, which include medications such as colesevelam and cholestyramine, which I hope I'm not butchering that name too much.

These medications are used for hypercholesterolemia.

They work by binding to bile acids in the intestine, which helps increase excretion of cholesterol and bring down LDL levels.

The key side effect with both of these medications is constipation as well as GI upset.

So some of my silly ways to try to remember these two medications is if you eat a lot of lamb, which is high in fat and cholesterol, you may need colesevelam to bring down your cholesterol levels.

Also, because these medications both start with the words Cole, I think about coleslaw, which is high in fiber, which you can eat to counteract the constipating effects of these medications.

So in terms of administration, you definitely want to advise your patient to increase their fiber and fluid intake to help prevent that constipation. They should take this medication with food and a full glass of water.

In addition, these medications can interfere with fat-soluble vitamin absorption. So this includes vitamins A, D, E, and K.

The way I remember which vitamins are fat soluble is I think about a fat deck of cards, and so that helps me remember A, D, E, and K.

We are going to cover our next class of antilipemic medications, which are fibric acid derivatives.

This class includes medications such as gemfibrozil and fenofibrate so you could see both of these medications have that Fib, which is how I remember that they are used for cholesterol, because I think if you ate more foods that were high in fiber, so F-I-B, then you wouldn't need a medication such as gemfibrozil or fenofibrate to lower your cholesterol. So it's a little bit of a stretch, but that's how I remember.

So these medications are used for hypercholesterolemia. They work by decreasing trigycleride production and transport. They also help increase levels of HDL, so that's our good cholesterol, our happy cholesterol.

Side effects can include GI upset, gallstones, hepatotoxicity, and muscle pain. So here we are again with hepatotoxicity and muscle pain. These are going to be very common side effects with cholesterol medication.

So in terms of teaching, you want to advise your patient to take this medication 30 minutes before breakfast and dinner, and we're also going to want to monitor their liver function during therapy because of the risk of hepatotoxicity.

Okay, the last medication we're going to cover here in this video is niacin.

Niacin is a water-soluble vitamin, it's B-3, and in large doses, it can be used to treat hypercholesterolemia by decreasing lipoprotein and triglyceride synthesis.

The key side effect with niacin is flushing of the face. So the way I remember this is that my face doesn't look very nice when I take niacin because of that flushing. Other side effects include GI upset, pruritus, which is itchiness, as well as hepatotoxicity and possible hyperglycemia.

So when your patient is taking niacin for hypercholesterolemia, you're going to want to monitor their liver function, because of that hepatotoxicity, and you're also going to want to use this medication cautiously in patients with diabetes because of the side effect of hyperglycemia.

Okay, in my next video, I will be covering vitamins, minerals, and electrolytes, which are used to correct imbalances in the bloodstream. So hang in there with me. We are almost through all these cardiovascular medications!


1 Response

kehinde

November 13, 2020

I ordered the Nursing flashcards and they are really helpful in my pharmacotherapeutic class.

Leave a comment

Comments will be approved before showing up.

Also in Nursing Pharmacology

Pharmacology, part 18: Nervous System Medications for Depression
Pharmacology, part 18: Nervous System Medications for Depression

by Cathy Parkes November 11, 2020

Key meds for depression: tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), and atypical antidepressants (buproprion, trazodone).
Read Article
Pharmacology 2020_17 Nervous Medications: Anxiety Medications
Pharmacology, part 17: Nervous System Medications for Anxiety

by Cathy Parkes November 09, 2020

Learn the key facts about some medications that are used to treat anxiety, including benzodiazepines (diazepam, lorazepam, midazolam, chlordiazepoxide) and non-benzodiazepines (buspirone).
Read Article
Pharmacology 2020_16 Cardiovascular Medications Electrolyte and Acid -Base Imbalances
Pharmacology, part 16: Cardiovascular Medications - Electrolyte & Acid/Base Imbalances

by Cathy Parkes November 06, 2020

Key meds used to treat electrolyte and acid/base imbalances: calcium, potassium, sodium bicarbonate, sodium polystyrene sulfonate (Kayexalate), and magnesium.
Read Article