Perfusion and Renal Elimination
6.11 Antilipemics
Antilipemic Medications
Antilipemic agents reduce hyperlipidemia that may lead to additional health problems such as stroke, myocardial infarction, angina, and heart failure. Medications should be used in adjunct with a healthy diet and exercise regime approved by the client’s health care provider.
Ezetimibe
Mechanism of Action
Ezetimibe blocks the absorption of cholesterol in the small intestines to reduce LDL.
Indications for Use
This medication is used for treatment of hyperlipidemia and familial hypercholesterolemia.
Nursing Considerations Across the Lifespan
If medication is combined with HMG-CoA reductase inhibitors, do not give to pregnant or breastfeeding clients.
Adverse/Side Effects
Use with caution when ezetimibe is combined with additional medication. Clients may experience arthralgia, rhabdomyolysis, hepatic impairment, dizziness, upper respiratory infections, or diarrhea if they are taking this medication. Minimal side effects were reported with monotherapy.[1]
Client Teaching & Education
Clients should take the prescribed medication as directed and avoid consuming grapefruit juice during drug therapy. The medication should be used with dietary modifications. If the client experiences muscle pain, tenderness, or weakness, this should be reported to the healthcare provider.[2]
Atorvastatin
Mechanism of Action
Atorvastatin inhibits HMG-CoA reductase and cholesterol synthesis, which reduces LDL (low density lipoprotein).
Indications for Use
This medication is used for hyperlipidemia and the prevention of cardiovascular disease.
Nursing Considerations Across the Lifespan
Do not use with clients who have hepatic disease.
This medication is contraindicated with clients who are pregnant or breastfeeding. Do not give to clients under 10 years of age.
Use caution with geriatric clients due to increased risk for myopathy.
Adverse/Side Effects
Clients who are pregnant or breastfeeding should not take this medication. A health care provider will assess routine liver function for a client taking atorvastatin. Nausea, diarrhea, dyspepsia, increase in blood glucose, rhabdomyolysis, myalgia, or muscle spasms may be produced by taking this medication. Rhabdomyolysis is a condition in which damaged skeletal muscle breaks down rapidly, causing muscle pain and weakness. Some of the muscle breakdown products are harmful to the kidneys and can cause kidney failure. There may be tea-colored urine or an irregular heartbeat with rhabdomyolysis. [3]
Client Teaching & Education
Clients should take the prescribed medication as directed and avoid consuming grapefruit juice during drug therapy. The medication should be used with dietary modifications. If the client experiences muscle pain, tenderness, or weakness, these should be reported to the healthcare provider.[4]
Antilipemics Medication Card
Now let’s take a closer look at the medication card for atorvastatin.[5]
Medication Card 6.11.1: Antilipemics (Atorvastain (lipitor))
Class: Antilipemics
Prototypes: Atorvastatin (Lipitor)
Mechanism: Atorvastatin inhibits HMG-CoA reductase and cholesterol synthesis, which reduces LDL (low density lipoprotein)
Therapeutic Effects
- Decreases Lipid levels LDL’s
- Improves blood flow through blood vessels by reducing cholesterol synthesis
Administration
- Administered PO 10-80 mg daily (dose depends on prescribing MD)
- Increasing doses happen every 2-4 weeks until therapeutic lipid blood levels
- Do not stop taking unless advised by doctor
- Keep away from children and moisture (avoid bathroom storage)
Indications
- Hyperlipidemia
- Prevention of Cardiac disease
- Prevention of Stroke
- Reduce risk post revascularization procedures
Contraindications
- People with Hepatic disease
- Pregnant or breast feeding
- Children under 10 years of age (make sure to check guidelines in you setting
- Cyclosporine
- Gemfibrozil
- Red yeast rice
Side Effects
- Nausea and diarrhea
- Dyspepsia
- Increased blood glucose
- Rhabdomyolysis- kidney damage resulting so watch for kidney function
- Myalgia
- Muscle pain and weakness
- Tea colored urine
- Irregular heart beat
- SAFETY: Report muscle pain, yellow skin, decrease in urine and abdominal pain to MD-serious complications can arise
Nursing Considerations
- Caution in giving to geriatric patient due to increased risk for myopathy
- Assess routine liver and kidney function tests and Hb1AC increases possible with statins
- Do not drink or eat grapefruit
- This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain. ↵
- uCentral from Unbound Medicine. https://www.unboundmedicine.com/ucentral ↵
- This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain. ↵
- uCentral from Unbound Medicine. https://www.unboundmedicine.com/ucentral ↵
- This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain. ↵