Pharmacology Exam 3 Review
Michelle Limoges・2 minutes read
First-line treatment for dyslipidemia includes statins that reduce blood lipid levels but can be hepatotoxic, necessitating liver function test monitoring. Other medications like bile acid sequestrants, niacin, fibric acid drugs, diuretics, Aces, Arbs, beta blockers, and calcium channel blockers can be used to manage hypertension and heart failure.
Insights
- Statins are the primary treatment for dyslipidemia, effectively reducing blood lipid levels but may cause hepatotoxicity and are contraindicated in pregnant or breastfeeding women due to potential harm to the fetus.
- Aces and Arbs are essential in managing hypertension by interfering with the Renin-Angiotensin System, reducing blood volume, and improving heart function, but require monitoring for hypotension and possible first-dose hypotension.
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Recent questions
What is the first-line treatment for dyslipidemia?
Statins
What are bile acid sequestrants used for?
Increase cholesterol excretion
What is the function of niacin in dyslipidemia treatment?
Decrease VLDL levels
How do fibric acid drugs like gemfibrozil impact hypertriglyceridemia?
Used for severe cases
What is the role of beta blockers in managing hypertension?
Lower heart rate
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Summary
00:00
Managing Dyslipidemia: Statins, Sequestrants, and Diuretics
- First-line treatment for dyslipidemia is statins, which interfere with cholesterol synthesis and are effective in reducing blood lipid levels.
- Statins can be hepatotoxic, necessitating routine liver function test monitoring due to potential liver damage.
- Contraindicated in pregnant or breastfeeding women due to teratogenic effects on the fetus.
- Adverse effect of statins includes rhabdomyolysis, leading to muscle breakdown and weakness.
- Bile acid sequestrants like cholestyramine bind with bile acids to increase cholesterol excretion through stool.
- Side effects of bile acid sequestrants may include GI upset and diarrhea, indicating poor tolerance.
- Niacin, a B complex vitamin, decreases VLDL levels and triglycerides, but can cause flushing, nausea, and hepatotoxicity.
- Fibric acid drugs like gemfibrozil are used for severe hypertriglyceridemia and may interact with warfarin, requiring monitoring of PT and INR.
- Diuretics are used to reduce blood volume in managing hypertension, with loop diuretics like furosemide causing hypokalemia and orthostatic hypotension.
- Potassium-sparing diuretics like spironolactone prevent potassium wasting but can lead to hyperkalemia and hormonal changes like gynecomastia.
15:59
Managing Hypertension: Medication Overview and Effects
- A common adverse effect of Aces is a dry, persistent cough, which is an expected adverse effect that patients may experience.
- Patients are advised to inform healthcare providers if they can tolerate the cough, as Aces are effective in controlling blood pressure.
- Aces work by inhibiting the conversion of Angiotensin 1 to Angiotensin 2 in the lungs, thus reducing blood pressure by interfering with the RAS system.
- Aces also decrease effective blood volume, increase cardiac output, and help treat heart failure by improving heart function.
- Patients should be screened for hypotension when taking Aces, as they can cause first-dose hypotension.
- Arbs, or Angiotensin 2 receptor blockers, block the action of Angiotensin 2 in the lungs, reducing blood volume and blood pressure.
- Arbs are typically used for patients who do not tolerate Aces well and are identified by names ending in "sartan" or "lartan."
- Beta blockers decrease heart rate and contractility to lower systemic blood pressure, making the heart more efficient in pumping blood.
- Calcium channel blockers block calcium ion channels to cause vasodilation, reducing blood pressure by increasing the space for blood flow.
- Combining antihypertensive medications like diuretics with Aces can have additive or synergistic effects in lowering blood pressure.
32:25
Managing Heart Failure with Medications
- Diuretics are used to reduce blood volume, followed by beta blockers like Metoprolol to control heart rate and blood pressure.
- Phosphodiesterase Inhibitors are reserved for advanced cases due to toxicity, requiring short-term therapy and increased calcium intake for myocardial contractions.
- Cardiac glycoside Dexin is crucial, with therapeutic levels between 0.8 to 2.0, monitoring for toxicity symptoms like arrhythmias, vision changes, and gastrointestinal issues, while ensuring proper patient teaching on signs, symptoms, and drug interactions.
