78 Questions
What is the prevalence of CYP2D6 functional deficiency in Caucasians and African Americans?
7%
What is the effect of statins on LDL cholesterol levels?
18-55% decrease
In which population is CYP2D6 functional deficiency rare?
Asians
What is the most effective drug class for reducing LDL cholesterol levels?
Statins
In which patient population are statins considered first-line therapy for dyslipidemia?
Children
What is the most common adverse effect of statins?
Muscle pain
What is hyperlipidemia?
An increase in the level of lipids (cholesterol and triglycerides) in the blood
Which enzyme controls the early rate-limiting step in the production of cellular cholesterol?
HMG–CoA reductase
What are bile acids' main function in the body?
To break down or metabolize fats into small molecules called micelles
What is cholesterol used to make?
Bile acids and steroid hormones
Which medication type is used to reduce blood lipid levels?
Cholesterol absorption inhibitors
What do fats break down into in the stomach?
Fatty acids, lipids, and cholesterol
What is the mechanism of action of cholestyramine in reducing serum cholesterol levels?
Promoting the excretion of bile acids in the feces
What is the primary adverse effect of cholestyramine?
Flatulence and abdominal discomfort
Why is cholestyramine contraindicated in people with complete biliary obstruction?
Bile is not secreted into the intestine
What nursing implication is important when administering cholestyramine with other drugs?
Administering the other drugs 1 hour before cholestyramine
In which patient population should caution be exercised when using cholestyramine due to the risk of hyperchloremic metabolic acidosis?
Patients with renal impairment
What is the primary intended effect of using cholestyramine along with a statin drug?
Reducing LDL cholesterol levels further
What is the recommended timing of administration for statins like atorvastatin?
At any time of the day
Which of the following is a common adverse effect of atorvastatin therapy?
Muscle pain or weakness
What is the main purpose of monitoring liver function in patients taking statins?
To detect liver damage
Which of the following foods may decrease the effects of atorvastatin?
Oat bran
Which drug class has the ability to reduce LDL cholesterol without being absorbed when taken orally?
Bile acid sequestrants
What is the main purpose of dyslipidemic drugs?
To lower high concentrations of fats in the blood
Which class of medications is recommended as first-line therapy in patients with PAD for secondary prevention and cardiovascular risk reduction?
HMG-CoA reductase inhibitors (statins)
Which statin is useful for treating dyslipidemia and is an overall tool in the primary prevention of cardiovascular disease?
Atorvastatin
What is the main enzyme inhibited by statins to decrease hepatic synthesis of cholesterol?
HMG-CoA reductase
Which class of medications may have an increased risk of drug interactions and problems with certain foods, such as grapefruit juice?
HMG-CoA reductase inhibitors (statins)
Which medication is known to decrease total serum cholesterol, LDL cholesterol, VLDL cholesterol, and triglycerides, while possibly increasing HDL cholesterol levels?
HMG-CoA reductase inhibitors (statins)
What clinical condition may warrant the use of vitamin niacin in specific situations?
High triglyceride level
What is the primary indication for the use of fibrates?
High serum triglyceride levels
Which drug is contraindicated in patients with severe renal impairment?
Fenofibrate
What is the main adverse effect of fibrates?
Gastrointestinal discomfort and diarrhea
Which patient population should be closely monitored when using fibrates due to the risk of renal disease as a serious complication?
Patients with diabetes mellitus
What is the primary mechanism of action of fibrates in reducing cholesterol levels?
Decreasing VLDL cholesterol production
Which drug interaction increases the risk of severe myopathy or rhabdomyolysis when used concurrently with fenofibrate?
Statins
What is the main excretion route for fenofibrate?
Renal elimination
What is the primary use of fibrates in patients with hypertriglyceridemia associated with diabetes, gout, gastritis, or ulcer disease?
Decreasing serum triglyceride values
How do fibrates affect hepatic production of triglycerides?
Decrease it
Which enzyme controls the early rate-limiting step in the production of cellular cholesterol?
HMG-CoA reductase
What is the primary use of fibrates in patients with hypertriglyceridemia associated with diabetes, gout, gastritis, or ulcer disease?
To reduce cholesterol levels
What is the main adverse effect of fibrates?
Liver damage
Which of the following foods may decrease the effects of atorvastatin?
Grapefruit juice
What is the main excretion route for fenofibrate?
Feces
In which patient population should caution be exercised when using cholestyramine due to the risk of hyperchloremic metabolic acidosis?
Patients with renal disease
Which class of medications is recommended as first-line therapy in patients with PAD for secondary prevention and cardiovascular risk reduction?
3-hydroxy-3methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins)
What is the main purpose of monitoring liver function in patients taking statins?
To detect potential adverse effects related to the medication
What is the primary mechanism of action of fibrates in reducing cholesterol levels?
Increase in lipoprotein lipase activity
What is the most common adverse effect of statins?
Severe myopathy or rhabdomyolysis
What is the primary indication for the use of fibrates?
Hypertriglyceridemia associated with diabetes, gout, gastritis, or ulcer disease
Which drug interaction increases the risk of severe myopathy or rhabdomyolysis when used concurrently with fenofibrate?
Gemfibrozil
Which of the following foods or beverages can increase the effects of atorvastatin?
Grapefruit juice
What is the recommended timing for the administration of most statins like atorvastatin?
In the evening or at bedtime
Which class of drugs can reduce LDL cholesterol without being absorbed when taken orally?
Bile acid sequestrants
What is the primary adverse effect of statin therapy that nurses should monitor for during the first months of treatment?
Muscle pain or weakness
Which drug interaction increases the effects of fluvastatin?
Grapefruit juice
What recommendation should be given to women of childbearing age who are prescribed statins?
Consider contraceptive counseling
What is the most common adverse effect of statins?
Skin rash
What is the primary enzyme inhibited by statins to decrease hepatic synthesis of cholesterol?
HMG-CoA reductase
In which patient population should caution be exercised when using cholestyramine due to the risk of hyperchloremic metabolic acidosis?
Patients with renal impairment
Which drug interaction increases the risk of severe myopathy or rhabdomyolysis when used concurrently with fenofibrate?
Cyclosporine and verapamil
What is the main excretion route for fenofibrate?
Biliary excretion
What is the effect of statins on LDL cholesterol levels?
10% decrease in LDL levels
What is the primary mechanism of action of cholestyramine in reducing serum cholesterol levels?
Binding bile acids in the intestinal lumen, preventing recirculation to the liver
What is the main adverse effect of cholestyramine?
Constipation
What is the primary intended effect of using cholestyramine along with a statin drug?
Decreasing LDL cholesterol levels
Which enzyme controls the early rate-limiting step in the production of cellular cholesterol?
HMG-CoA reductase
What is the primary indication for the use of fibrates?
To reduce blood lipid levels
Which class of medications may have an increased risk of drug interactions and problems with certain foods, such as grapefruit juice?
Statins
What is the primary indication for the use of fibrates?
Lowering high serum triglyceride values
Which patient population should caution be exercised when using fibrates due to the risk of renal disease as a serious complication?
Patients with diabetes mellitus
What is the main adverse effect of fibrates?
GI discomfort and diarrhea
How do fibrates affect hepatic production of triglycerides?
Decrease it
What is the primary use of fibrates in patients with hypertriglyceridemia associated with diabetes, gout, gastritis, or ulcer disease?
Reducing serum triglyceride values
What is the main enzyme inhibited by statins to decrease hepatic synthesis of cholesterol?
HMG-CoA reductase
What is the primary excretion route for fenofibrate?
Urinary elimination
Which drug interaction increases the risk of severe myopathy or rhabdomyolysis when used concurrently with fenofibrate?
(Statins) HMG-CoA reductase inhibitors
What is the main purpose of monitoring liver function in patients taking statins?
To assess for abnormal elevations of serum aminotransferases
Test your knowledge about the herb and dietary interactions of atorvastatin, including substances that decrease or increase its effects, and the timing of medication administration.
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