Pharmacology Ch 47 (2) Lipid-Lowering Agents
- Begin a low-fat diet
- Walk regularly
Rationale: Decreasing dietary fat intake and instituting regular aerobic exercise will
decrease weight, increase cardiovascular health, and reduce risk factors of metabolic
syndrome. - ✔✔A client with metabolic syndrome is encouraged to implement
nonpharmacologic measures improve his risk factors. What do those
non-pharmacologic measures include? (Select all that apply.)
Blocking the enzyme that is involved in cholesterol synthesis
Rationale: HMG-CoA reductase inhibitors, such as atorvastatin, block the enzyme
involved in cholesterol synthesis. - ✔✔When describing the action of atorvastatin,
which would the nurse include?
at bedtime.
Rationale: Patients who are prescribed extended-release lovastatin should take the
medication at bedtime, without food, to be most effective. This is because most
cholesterol synthesis occurs during this time. Immediate-release lovastatin should be
taken after the evening meal. It would not be appropriate to take lovastatin in the
afternoon or the early morning. - ✔✔A 62-year-old man has been prescribed
extended-release lovastatin. The nurse will instruct the patient to take the medication:
Brownish colored urine
Rationale: Prolonged use of lovastatin may damage skeletal muscle; the increased
bilirubin from the dead cells changes the color of the urine from amber to brown.
Tanned and reddish color skin indicates photosensitivities caused by the drug and are
general adverse effects. - ✔✔A nurse is caring for a patient who is receiving
lovastatin. Which assessment by the nurse would indicate that there is possible
damage to the patient's skeletal muscle as a result of the drug therapy?
, "This is an expected adverse effect of the drug. It should subside in time."
Rationale: Large doses of nicotinic acid produce peripheral vasodilation, mostly in the
cutaneous vessels of the face, neck, and chest. Vasodilation results in flushing of the
skin and is usually transient. The vasodilation is due to the histamine release caused
by the medication. A nurse would never tell a client not to worry and to stop taking the
medication, unless the prescriber told her to. The flushing should subside and will not
be present for the duration of the course of the drug. - ✔✔A female client is taking a
large dose of nicotinic acid to treat hyperlipidemia. She calls the clinic and reports that
her face, neck, and chest are red. Which would be an appropriate response by the
nurse?
Increase in plasma concentration of lovastatin
Rationale: Patients with severe renal disease may have an increased plasma
concentration of lovastatin because 10% of the drug is eliminated in the urine. Patients
with renal disorders are not likely to experience a decrease in LDL or an increase in the
statin tolerance level. - ✔✔A nurse is caring for a male patient who has a diagnosis of
coronary artery disease (CAD). His drug therapy includes lovastatin. Because the
patient has a history of severe renal disease, the nurse will assess for a(n):
oxidizing cholesterol to bile acids.
Rationale: Bile acid sequestrants, such as cholestyramine, promote the oxidation of
cholesterol to bile acids. - ✔✔Several months of treatment with a statin accompanied
by lifestyle modifications have failed to appreciably improve a patient's cholesterol
levels. Consequently, the patient has been prescribed cholestyramine. The nurse
should recognize that this drug achieves its therapeutic effect by:
Rationale: Overall, the most effective blood lipid profile for prevention or management
of metabolic syndrome and its sequelae is high HDL cholesterol, low LDL cholesterol,
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