6.11 Antilipemics
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.
Atorvastatin
Mechanism of Action: Atorvastatin inhibits HMG-CoA reductase and cholesterol synthesis, which reduces low-density lipoprotein (LDL).
Indications: This medication is used for hyperlipidemia and the prevention of cardiovascular disease.
Nursing Considerations: 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 elderly clients due to increased risk for myopathy.
Side Effects/Adverse Effects: 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.[1]
Health Teaching & Health Promotion: 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 health care provider.[2]
Now let’s take a closer look at the medication grid on atrovastatin in Table 6.11a.[3]
Table 6.11a Atorvastatin Medication Grid
| Class/Subclass | Prototype/Generic | Nursing Considerations | Therapeutic Effects | Side/Adverse Effects |
| HMG-CoA Reductase Inhibitor | atorvastatin
|
Take at the same time each day, with or without food
Report muscle weakness, feeling tired, abdominal pain, or yellowing of skin or eyes Clients who are pregnant or breastfeeding should not take this medication |
Reduce LDL | Rhabdomyolysis, myalgia, and muscle spasms
Abnormal liver enzymes May increase blood glucose Nausea, diarrhea, and dyspepsia |
Ezetimibe
Mechanism of Action: Ezetimibe blocks the absorption of cholesterol in the small intestines to reduce LDL.
Indications: This medication is used for treatment of hyperlipidemia and familial hypercholesterolemia.
Nursing Considerations: If medication is combined with HMG-CoA reductase inhibitors, do not give to pregnant or breastfeeding clients.
Side Effects/Adverse 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 mon