NUR 2474 Module 6 Study Guide: Cardiovascular &
Hematologic
LIPOPROTEINS
- High-density (HDL) = "Good"
- Low-density (LDL) = "Bad"
Nonpharmacological Interventions for Hyperlipidemia
- Lifestyle changes
○ Routine exercise
○ Smoking cessation
- Dietary changes
○ Reduce saturated fats
○ 30% or less fat in caloric intake
○ 300 mg/day or less of cholesterol
HMG-COA REDUCTASE INHIBITORS (STATINS)
- Decreases LDLs
- Increases HDLs
- Side Effects
○ GI distress
○ Constipation
○ Muscle cramps
○ Fatigue
○ Hepatotoxic
○ Myopathy
▪ Risk for rhabdomyolysis (death of muscle fibers which them releases into the blood)
▪ Monitor CK (creatine kinase)
- Interactions
○ Grapefruit juice (inhibits metabolism)
○ Erythromycin, ketoconazole, amiodarone
- Nursing Interventions
○ Monitor blood lipid levels (LDL, HDL, Triglycerides)
○ Monitor liver labs
▪ Baseline, 12 weeks, Q6 months
- Education
○ May take 2-3 weeks to have therapeutic effect
○ Report signs of liver dysfunction
○ Report muscles aches, pain, and tenderness
○ Do not take while pregnant or lactating
○ Take in evening with meal (especially lovastatin)
Lovastatin
Atorvastatin
Simvastatin
Pravastatin
Rosuvastatin
Fluvastatin
BILE-ACID SEQUESTRIANTS
- Action
○ Reduce LDL by binding with bile-acids in the intestine
○ Forms insoluble complexes with bile salts (increasing bile loss in stool)
- Side Effects
○ Constipation
○ Flatulence
, ○ Cramping
- Interactions
○ Interferes with all fat soluble vitamins (A,D,E,K) and other medications
- Considerations
○ Also used to treat type II diabetes
▪ At risk for hypoglycemia (monitor glucose levels)
○ Monitor cholesterol and triglycerides
- Education
○ Take other meds and vitamins 1 hour prior or 4 hours after
○ When in powder form, mix with water, juice, or applesauce
○ Increase fiber and fluids
○ Take with food and full glass of water
Colesevelam Welchol
Cholestyramine Questran
SELECTIVE CHOLESTEROL-ABSORPTION INHIBITORS
Ezetimibe
ORGANIC NITRATES
Nitroglycerin
- Mechanism of Action
○ Promotes vasodilation
- Side Effects/ Adverse Reactions
○ Headache
○ Hypotension
○ Flushing
○ Dizziness
○ Weakness
○ Syncope
- Routes of Administration
○ Sublingual
○ Topical
○ Aerosol spray
○ IV
○ ER Tabs = buccal and PO
- Considerations
○ Do not abruptly discontinue (will case rebound hypertension)
○ Do not use Viagra (or other ED meds)
○ Can cause severe hypotension
CLOT FORMATION AND PREVENTION
- Arterial clot formation
○ Platelets initiate process
○ Fibrin formations occurs
○ RBCs are trapped in fibrin mesh
- Venous clot formation
○ Platelet aggregation with fibrin that attaches to RBCs
- Rx used for…
○ DVT
○ PE
○ MI
○ Artificial heart valves
○ Stroke
ANTICOAGULANTS
Hematologic
LIPOPROTEINS
- High-density (HDL) = "Good"
- Low-density (LDL) = "Bad"
Nonpharmacological Interventions for Hyperlipidemia
- Lifestyle changes
○ Routine exercise
○ Smoking cessation
- Dietary changes
○ Reduce saturated fats
○ 30% or less fat in caloric intake
○ 300 mg/day or less of cholesterol
HMG-COA REDUCTASE INHIBITORS (STATINS)
- Decreases LDLs
- Increases HDLs
- Side Effects
○ GI distress
○ Constipation
○ Muscle cramps
○ Fatigue
○ Hepatotoxic
○ Myopathy
▪ Risk for rhabdomyolysis (death of muscle fibers which them releases into the blood)
▪ Monitor CK (creatine kinase)
- Interactions
○ Grapefruit juice (inhibits metabolism)
○ Erythromycin, ketoconazole, amiodarone
- Nursing Interventions
○ Monitor blood lipid levels (LDL, HDL, Triglycerides)
○ Monitor liver labs
▪ Baseline, 12 weeks, Q6 months
- Education
○ May take 2-3 weeks to have therapeutic effect
○ Report signs of liver dysfunction
○ Report muscles aches, pain, and tenderness
○ Do not take while pregnant or lactating
○ Take in evening with meal (especially lovastatin)
Lovastatin
Atorvastatin
Simvastatin
Pravastatin
Rosuvastatin
Fluvastatin
BILE-ACID SEQUESTRIANTS
- Action
○ Reduce LDL by binding with bile-acids in the intestine
○ Forms insoluble complexes with bile salts (increasing bile loss in stool)
- Side Effects
○ Constipation
○ Flatulence
, ○ Cramping
- Interactions
○ Interferes with all fat soluble vitamins (A,D,E,K) and other medications
- Considerations
○ Also used to treat type II diabetes
▪ At risk for hypoglycemia (monitor glucose levels)
○ Monitor cholesterol and triglycerides
- Education
○ Take other meds and vitamins 1 hour prior or 4 hours after
○ When in powder form, mix with water, juice, or applesauce
○ Increase fiber and fluids
○ Take with food and full glass of water
Colesevelam Welchol
Cholestyramine Questran
SELECTIVE CHOLESTEROL-ABSORPTION INHIBITORS
Ezetimibe
ORGANIC NITRATES
Nitroglycerin
- Mechanism of Action
○ Promotes vasodilation
- Side Effects/ Adverse Reactions
○ Headache
○ Hypotension
○ Flushing
○ Dizziness
○ Weakness
○ Syncope
- Routes of Administration
○ Sublingual
○ Topical
○ Aerosol spray
○ IV
○ ER Tabs = buccal and PO
- Considerations
○ Do not abruptly discontinue (will case rebound hypertension)
○ Do not use Viagra (or other ED meds)
○ Can cause severe hypotension
CLOT FORMATION AND PREVENTION
- Arterial clot formation
○ Platelets initiate process
○ Fibrin formations occurs
○ RBCs are trapped in fibrin mesh
- Venous clot formation
○ Platelet aggregation with fibrin that attaches to RBCs
- Rx used for…
○ DVT
○ PE
○ MI
○ Artificial heart valves
○ Stroke
ANTICOAGULANTS
