Wk 3 notes 5 - TREATMENT OF HYPERLIPIDEMIAS(ALSO CALLED DYSLIPIDEMIAS Treatment of Hyperlipidemias(also called dyslipidemias Initial therapy for

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TREATMENT OF HYPERLIPIDEMIAS (ALSO CALLED DYSLIPIDEMIAS) Treatment of Hyperlipidemias (also called dyslipidemias) Initial therapy for all patients with hyperlipidemia should be dietary modification. However, most patients will require the addition of medication to reduce cholesterol and achieve desirable levels of LDL cholesterol (the actual numerical goal is defined by the patient's number of risk factors for, or presence of, coronary artery disease). The five major categories of medications used to treat lipid disorders are Bile Acid Sequestrants, Nicotinic Acid Derivatives, Fibric Acids, HMG Co-A Reductase Inhibitors (also called Statins) and Cholesterol Absorption Inhibitors. These drugs vary in their effects on lipids so selection is guided by the goal of therapy: to reduce LDL, reduce triglycerides or raise HDL. List of Available Bile-Acid Sequestrants cholestyramine (Questran) (Cholebar) colestipol (Colestid) colesevelam hydrochloride (WelChol) Pharmacodynamics of the Bile-Acid Sequestrants Bile-acid sequestrants are resins that irreversibly bind to the naturally occurring bile salts in the G.I. tract, preventing their action in dietary fat absorption. By preventing the absorption of dietary fat and cholesterol (and the reabsorption of the bile salts themselves), the pool of bile salts in the body is decreased. In order to replace the diminishing pool of bile salts, the body mobilizes cholesterol from storage sites in the adipose tissue in order to convert it into more bile salts. By these mechanisms, the bile-acid sequestrants decrease entry of cholesterol into the body and reduce the amount of stored cholesterol by converting it to bile salts. Pharmacokinetics of the Bile-Acid Sequestrants The bile-acid sequestrants are administered orally. They (and anything bound to them) are not appreciably absorbed. They are excreted in the stool. Advantages of Using the Bile Acid Sequestrants in the Treatment of Familial Hyperlipidemia - Administered orally (with large amounts of water). - Administered once-a-day (cholestyramine) or BID (colestipol); colesevelam can be given once-a-day or divided BID. - Drug is not absorbed; eliminates the risk of systemic adverse effects from the drug itself. - Dual mechanisms of action; inhibits absorption of dietary fat and cholesterol and 1
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TREATMENT OF HYPERLIPIDEMIAS (ALSO CALLED DYSLIPIDEMIAS) lowers total body cholesterol stores. - Useful in any of the familial hypercholesterolemias; can be effective in a number of genetic types of hyperlipedemia. - Lowers both total cholesterol and LDL cholesterol. - Minimal adverse effects; considered very safe among the antilipidemic drugs. - Can be used synergistically with the other lipid-lowering drugs to produce a potentiative, pharmacodynamic drug-drug interaction on serum lipids. - Can be used safely in children and in pregnancy.
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This note was uploaded on 05/19/2011 for the course NURSING 517/617 taught by Professor Lipstate during the Spring '11 term at University of Louisiana at Lafayette.

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Wk 3 notes 5 - TREATMENT OF HYPERLIPIDEMIAS(ALSO CALLED DYSLIPIDEMIAS Treatment of Hyperlipidemias(also called dyslipidemias Initial therapy for

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