Category: Fundamentals
Variant angina is caused by coronary artery spasm, which restricts blood flow to the myocardium. Variant angina can produce pain at any time. Alternative names for variant angina are vasospastic angina and Prinzmetal's angina.
Category: Fundamentals
Stable angina is triggered most often by an increase in physical activity. Emotional excitement, large meals and cold exposure may also precipitate an attack. This condition is also known as exertional angina or angina of effort.
Category: Fundamentals
The fibric acid derivatives, also known as fibrates, are the most effective drugs we have for lowering triglyceride levels. In addition, these drugs can raise HDL cholesterol, but have little or no effect on LDL cholesterol.
Category: Fundamentals
Niacin reduces LDL cholesterol by 14-17%, TGs by 28-35% and raises HDL cholesterol by 28-35%. Triglycerides begin to fall within the first 4 days of therapy. LDL levels decline more slowly, taking 3 to 5 weeks for maximum reductions.
Category: Fundamentals
If a 30% to 40% reduction in LDL is deemed sufficient, any statin will do. If LDL levels must be lowered by more than 40%, then atorvastatin or simvastatin may be preferred. These two drugs are highly effective and clinical experience is extensive.
Category: Fundamentals
Statins can cause liver injury in some individuals. Progression to liver failure rarely occurs. Because of this risk, product labeling recommends that liver function tests (LFTs) be done before treatment and every 6 to 12 months thereafter.
Category: Fundamentals
Statins can injure muscle tissue. Mild injury occurs in 5% to 10% of patients. Symptoms include muscles aches, tenderness or weakness that may be localized to certain muscle groups or diffuse. Rarely, mild injury progresses to myositis.
Category: Fundamentals
Because cholesterol synthesis normally increases during the night, statins are most effective when given in the evening. If statin therapy is stopped, serum cholesterol will return to pretreatment levels within weeks to months.
Category: Fundamentals
Statins have a profound effect on LDL cholesterol. Low doses decrease LDL cholesterol by about 25% and larger doses decrease levels by as much as 63%. Reductions are significant within 2 weeks and maximal within 4 to 6 weeks.
Category: Fundamentals
HMG-CoA reductase inhibitors, commonly called statins, are the most effective drugs for lowering LDL and total cholesterol. In addition, they can raise HDL cholesterol and lower TGs in some patients.
Category: Fundamentals
Lifestyle changes are first line measures used to lower LDL cholesterol. They focus on four main issues: diet, exercise, weight control and smoking cessation. These measures should be implemented before trying drugs.
Category: Fundamentals
High-density lipoproteins
(HDLs) contain cholesterol as their primary core lipid and account for 20% to 30% of all cholesterol in blood. In contrast to LDLs, HDLs carry cholesterol from peripheral tissues back to the liver.
Category: Fundamentals
Of all the lipoproteins, LDLs make the greatest contribution to coronary atherosclerosis. The probability of developing CHD is directly related to the level of LDLs in blood. By reducing LDL levels, we decrease the risk of CHD.
Category: Fundamentals
Low-density lipoproteins (LDL) contain cholesterol as their primary core lipid and account for the majority (60% to 70%) of all cholesterol in blood. The physiologic role of LDLs is delivery of cholesterol to nonhepatic tissues.
Category: Fundamentals
Very-low-density lipoproteins (VLDL) contain mainly triglycerides. The main role of VLDLs is to deliver triglycerides from the liver to adipose tissue and muscle, which can use the triglycerides as fuel.
Category: Medical Surgical Nursing
Lidocaine undergoes rapid hepatic metabolism. If the drug were administered orally, most of each dose would be inactivated on its first pass through the liver. For this reason, administration is parenteral, almost always by IV infusion.
Category: Medical Surgical Nursing
Lidocaine has three significant effects on the heart: (1) blocks cardiac sodium channels; (2) reduces automaticity in the ventricles and His-Purkinje system and (3) accelerates repolarization (shortens the action potential duration and ERP).
