1. Antilipemic Agents Goals: - Lower LDL - Raise HDL - Possibly Lower VLDL
   1. Atorvastatin
      1. Class:
         1. HMG-CoA reductase inhibitors
      2. MOA:
         1. Inhibits cholesterol synthesis within the liver by blocking HMG-CoA reductase from converting into Mevalonate
      3. Indications:
         1. Hypercholesterolemia
         2. Primary & Secondary CV prevention
         3. Post MI Therapy
         4. DM/DMII
      4. Adverse Effects:
         1. Myopathy/rhabodmyolysis
         2. Hepatotoxicity
         3. New onset DM (rare)
         4. Teratogenicity (Category X)
      5. Nursing Considerations:
         1. Administer in evening
         2. Monitor LF and CK
         3. Pt education on contraception and myopathy
   2. Colesevelam
      1. Class:
         1. Bile-acid sequestrant
      2. MOA:
         1. Binds to bile acids (in the GI tract) to prevent absorption and promote excretion Result: LDL cholesterol reduction
      3. Indications:
         1. Adjunctive therapy in hypercholesterolemia, often with statin medications
      4. Adverse Effects:
         1. GI
            1. Constipation
            2. Bloating
            3. Indigestion
            4. Nausea
      5. Nursing Considerations:
         1. Med interactions -Decreases absorption
            1. Thiazides
            2. Digoxin
            3. Warfarin
         2. Administer other meds 1 hr before or 4 hrs after bile-acid sequestrant admin
         3. Increase fluids & fiber prior to administering laxatives
         4. Take with food and water
   3. Gemfibrozil
      1. Class:
         1. Fibric acid derivative (fibrate)
      2. MOA:
         1. Lowers VLDLs levels to reduce TG levels, raises HDL, little to no effect on LDL
      3. Indications:
         1. Hypertriglyceridemia
         2. Mixed dyslipidemia
      4. Adverse Effects:
         1. GI disturbance
            1. nausea
            2. ab pain
            3. diarrhea
         2. Risk of gallstones
         3. Myopathy/rhabdomyolysis
         4. Hepatotoxicity
      5. Nursing Considerations:
         1. Can increase anticoagulant effects in patients on warfarin
            1. monitor for bleeding and INR
         2. Periodic LFT
         3. Patient education on myopathy and gall stones
2. Medical Acronyms