Copyright 2013 Wolters Kluwer Health Lippincott Williams Wilkins Bile Acid

Copyright 2013 wolters kluwer health lippincott

This preview shows page 14 - 23 out of 40 pages.

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Bile Acid Sequestrants (cont.) Actions Binds bile acids in the intestine, allows excretion in feces instead of reabsorption, liver to use more cholesterol & LDL to make more bile acids, and serum cholesterol levels to fall Indications Reduces elevated serum cholesterol in patients with primary hypercholesterolemia, pruritus associated with partial biliary obstruction Pharmacokinetics Not absorbed systemically Excreted in the feces
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Bile Acid Sequestrants (cont.) Contraindications Allergy Complete biliary obstruction Abnormal intestinal function Pregnancy and lactation
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Question What would cause a drug-drug interaction with bile acid sequestrants? A. Loop diuretics B. Thyroid hormones C. Water soluble vitamins D. Mineralocorticoids
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer b. Thyroid hormones Rationale: Drug-to-Drug Interactions: malabsorption of fat- soluble vitamins; thiazide diuretics, digoxin, warfarin, thyroid hormones, and corticosteroids
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Bile Acid Sequestrants (cont.) Adverse Effects Headache, anxiety, fatigue, and drowsiness Direct GI irritation Nausea, constipation Increased bleeding times Vitamin A and D deficiencies Rash, muscle aches and pains Drug-to-Drug Interactions Malabsorption of fat-soluble vitamins Thiazide diuretics, digoxin, warfarin, thyroid hormones, and corticosteroids decreased absorption of these drugs
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Prototype Bile Acid Sequestrants
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Considerations for Bile Acid Sequestrants Assessment: History and Physical Exam Nursing Diagnosis Implementation Evaluation
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins HMG-CoA Inhibitors aka Statins Atorvastatin (Lipitor) Fluvastatin (Lescol) Lovastatin (Mevacor) Pitavastatin (LIvalo) Pravastatin (Pravachol) Rosuvastatin (Crestor) Simvastatin (Zocor)
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins HMG-CoA Inhibitors (cont.) Actions Inhibits HMG-CoA, decreases serum cholesterol levels, LDLs, and triglycerides, increases HDL levels Indications Adjunct to diet in the treatment of elevated cholesterol, triglycerides, and LDL; increase HDL-C in patients with primary hypercholesterolemia; treat familial hypercholesterolemia and two+ risk factors for CAD
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