Chapter 21 & 22

Question 1

Metabolic Syndrome is a condition that puts a patient at risk for developing cardiovascular disease. It cannot be controlled by
A. Regular exercise
B. Maintaining a healthy weight
C. Not smoking 
D. Decreasing stress
E. Genetic predisposition

Answer 1

Genetic predisposition

Question 2

Patients taking which cholesterol-lowering agent may require supplements of fat-soluble vitamins?
A. Bile acid binding resins
B. Nicotonic acid
C. HMG-CoA reductase inhibitors
D. Fibrin acids

Answer 2

Bile acid binding resins

Question 3

Which administration strategy can a patient implement to reduce flushing and GI discomfort, common adverse effects of niacin therapy?
A. Take on an empty stomach
B. Take with acetaminophen 
C. Take with meals
D. Take at bedtime

Answer 3

Take with meals

Question 4

Which antilipemic drug acts by blocking the absorption of cholesterol from the small intestine?
A. Omega 3 fatty acid (Omacor)
B. Ezetimibe (Zetia)
C. Gemfibrozil (Lopid)
D. Rosuvastatin (Crestor)

Answer 4

Ezetimibe (Zetia)

Question 5

What is hyperlipidemia

Answer 5

Elevation of cholesterol and triglycerides in the blood

Question 6

What are 3 goal treatments for patients with metabolic syndrome

Answer 6

1. Lower and control the hypertension
2. Lower the dyslipidemia
3. Lower and control the blood glucose

Question 7

What is dyslipidemia

Answer 7

Abnormalities of one or more of the blood fats

Question 8

Which is the most favorable lipid level?
A. Elevated LDL
B. Decreased HDL
C. Elevated HDL
D. Elevated triglycerides

Answer 8

Elevated HDL

Question 9

Low levels of HDL and High levels of LDL are risks for ____ and _____.

Answer 9

1. Atherosclerosis

2. Coronary Heart Disease

Question 10

Atherosclerosis is characterized by what?

Answer 10

Fatty deposits in artery walls.

Question 11

Atherosclerosis is cause by what?

Answer 11

1. Genetic abnormalities

2. Secondary factors such as: lifestyle, drugs, or underlying diseases.

Question 12

Your patient has been diagnosed with Atherosclerosis. What would be proper patient education and health promotion?

Answer 12

1. Consume high-bulk foods: whole grains, raw fruits and vegetables
2. Lots of water to minimize constipation
3. Avoid high-cholesterol foods: liver, egg yolks, meats, fried foods, fatty desserts, nuts
4. Decrease stress
5. Importance of weight reduction and exercise
6. Smoking cessation
7. Pertinent drug information
8. Long-term regular follow-up care
9. Moderate alcohol consumption
10. Dash diet

Question 13

Primary treatment of Hyperlipidemia is what?

Answer 13

Therapeutic lifestyle changes (TLCs)

Question 14

What are examples of TLCs?

Answer 14

1. Weight reduction
2. Exercise
3. Diet low in cholesterol and fat

Question 15

What are drug therapies for treating Hyperlipidemia?

Answer 15

1. Bile acid-binding resins
2. Niacin
3. HMG-CoA reductase inhibitors
4. Fibric acids
5. Omega-3 fatty acids
6. Antilipemic agents

Question 16

What would be the reason why you would use Antilipemic agents to treat Hyperlipidemia?

Answer 16

If diet and exercise are unsuccessful.

Question 17

Combining ______ and _____ or ______ can lower LDL by 40% to 50%

Answer 17

Bile acid-binding resins

1. Niacin
2. Statin

Question 18

What are the Drug Classes that treat Dyslipidemias?

Answer 18

1. Bile Binding Resin
2. Niacin (Nicotinic Acid)
3. HMG-CoA Reductase Inhibitors (Statins)
4. Fibric Acids
5. Miscellaneous Antilipemic Agents

Question 19

True or False: Colesevelam is an HMG-CoA Reductase Inhibitor?

Answer 19

False; it is a Bile Binding Resin.

Question 20

How do Bile Binding Resins work?

Answer 20

1. Bind to bile acids

2. Promote increased metabolism of cholesterol

Question 21

Why would a patient be given a Bile Binding Resin?

Answer 21

To decrease elevated cholesterol.

Question 22

Common adverse effects of Bile Binding Resins affect what part of the body?

Answer 22

GI tract.

Question 23

Your patient is exhibiting signs of Vitamin K deficiency and given a drug to treat Dyslipidemia. What type of drug was the patient given?

Answer 23

Bile Binding Resin

Question 24

How do Niacin (Nicotinic acid) drugs work?

Answer 24

1. Inhibit VLDL synthesis by liver cells

2. Decrease LDL and Triglyceride production

Question 25

Your patient which has been diagnosed with Dyslipidemia has been constipated for 2 hours. She is experiencing a common adverse effect of what drug?

Answer 25

1. Cholestyramine 2. Colestipol 3. Colesevelam

Question 26

True or False: You should use caution when giving a diabetic patient Niacin.

Answer 26

True.

Question 27

Your patient who has been diagnosed with Dyslipidemia is experiencing signs of hepatotoxicity. What type of drug has this patient been given?

Answer 27

Niacin (Nicotinic acid)

Question 28

A patient that has been given Niacin feels dizzy and lightheaded when she sits up to get out of bed. What could be done to reduce this effect?

Answer 28

Give patient Aspirin (325 mg) or Ibuprofen (200 mg) 30 minutes before each dose of Niacin, or take with food. Also be aware that a tolerance will develop quickly!

Question 29

How do HMG-CoA Reductase Inhibitor drugs work?

Answer 29

1. Inhibits enzyme responsible for converting HMG-CoA to mevalonate 2. Reduces liver cholesterol

Question 30

A patient has been given medication for Dyslipidemia and is now experiencing liver dysfuntion. What type of drug has been given?

Answer 30

HMG-CoA Reductase Inhibitor (Statins).

Question 31

What drugs are classified as HMG-CoA Reductase Inhibitors (Statins)?

Answer 31

1. Lipitor 2. Mevacor 3. Pravachol (Pravastatin) 4. Crestor 5. Zocar (Simvastatin) 6. Caduet

Question 32

How would you administer Mevacor?

Answer 32

With food during the evening meal to enhance absorption.

Question 33

What would you want to avoid giving a patient who is on a HMG-CoA Reductase Inhibitor (Statins)?

Answer 33

Grapefruit juice 1. Inhibits metabolism of statins 2. Increases plasma concentrations and increases risk of myopathy