NURS 3220 Lecture Notes - Lecture 15: Hives, Gallstone, Vasodilation
Document Summary
High homocysteine levels (decreased with folic acid, vit b6, vit b12. High c-reactive protein (crp)- predictor of heart disease! Kidneys: decrease gfr rate, hypertension, renal failure. Decrease ldl production: rate limiting enzyme is hmg coa reductase. Bind dietary fats so they are not absorbed, triggering movement of ldl to liver. Side effects of many drugs that lower ldl: Liver: liver damage, esp. statins, avoid with damaged liver, check baseline liver enzymes. Muscle: myopathy leading to muscle pain, extreme is rhabdomyolitis, associated with renal failure report muscle pain and tenderness. Hmg-coa reductase inhibitors statins atorvastatin (lipitor) simvastatin (zocor) lovastatin (mevacor) fluvastatin (lescol) pravastatin (pravachol) rosuvastatin (crestor) red yeast rice (contains lovastatin; levels vary wildly) Inhibits the hepatic enzyme (hmg-coa reductase) that synthesizes cholesterol. Slight decrease in triglycerides (except lipitor decreases tg by 30%) Proven decreased mortality in patients with cad (secondary prevention) Decreased mortality in pts without cad (primary prevention) Decreased risk 1st heart attack, stroke, and type 2 diabetes.
