Repetition of Medications to Lower LDL Cholesterol Levels – Statins (Nursing)

by Rhonda Lawes, PhD, RN

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    00:00 Statins, we talked about these.

    00:02 These have very fancy names, right? HMG-CoA reductase inhibitors -yeah, let's break this down because statins are gonna stick in your brain much easier.

    00:13 We call them statins because their generic name ends in -statin - atorvastatin, eccetera.

    00:20 So that's why they get that nickname statins.

    00:22 These are currently the most effective drugs for lowering LDL cholesterol levels.

    00:27 Now there's lots of debate of how much of the impact can be related to diet, how much of it to drugs.

    00:33 You need them both.

    00:35 If you can work at diet and exercise and have your cholesterol under control, good job but if that doesn't work for you, or the patient's unable to be compliant, you really should consider a statin.

    00:46 Now what kind of patient would be probably highest at risk? Think back, look at the nine risk factors we did.

    00:54 Put together a profile of the patient that would be at higher risk for cardiovascular events like this, and atherosclerosis and who would we want to be on a statin.

    01:05 Okay, somebody with high or low blood pressure? Right, somebody who has hypertension.

    01:11 What other diagnoses might they have? They might have diabetes, we would want them on a statin.

    01:19 So you see how we start to put these diagnoses together and these risk factors? That's why it matters that you spend time understanding how the disease works because you don't ever get a patient with just one thing - one problem, they come with all these problems and issues.

    01:36 So your knowledge as a nurse, of knowing how all these systems work and how the disease processes work i.e. knowing normal and then you recognize abnormal, we can help our patients live that much better of a life.

    01:51 So statins, that's why when people ask about why would I go on a statin? I want you to be able to speak to that because they're the most effective drugs for lowering LDL cholesterol levels.

    02:01 Take a look at our picture there, you'll see that's clearly the liver, right? Cool.

    02:06 Then you see the receptors that you have there and the little LDLs falling from the sky? Well if I take a statin, see what happens? First I had that many LDL receptor now I've got that many receptors.

    02:19 So if I increase the number of LDL receptors in the liver, that means I'll have less LDL in the serum or the blood because more of it is taken back to the liver.

    02:32 Cool.

    02:32 So if I have more LDL receptors, the more the LDLs gonna stay in the liver rather than being in the blood and I'll be able to measure that or the effectiveness of a statin by looking at their cholesterol levels in their blood.

    02:47 Remember that's a sample that's drawn from the vein.

    02:49 More receptors means more LDL in the liver, not in the blood and I'll be able to measure the effectiveness of a statin by looking at their lab work - their HDL and their LDL.

    03:01 Why am I emphasizing effectiveness? Because that's good practice as a nurse and secondly that's gonna be a focus and that you are able to recognize let's say, in an exam question, if a patient's treatment plan is effective.

    03:17 Now that's a skill you want for practice most of all but the exams are what you have to get through in order to get to practice.

    03:24 So we talked a little bit, pause for a minute just in your mind and see if you can explain to yourself how statins work in regard to LDLs without looking at your notes.

    03:38 Cool.

    03:39 I love it when you take the time to study as you go with us because I want to save you time in nursing school.

    03:46 So you got this, statins, they increase the number of LDL receptors in the liver.

    03:50 Less LDL in the blood means more in the liver.

    03:54 Now this is a problem for the patients, it's ongoing.

    03:57 They may have to take these drugs for life if we can't manage cholesterol with lifestyle and diet but lower LDL levels can slow the progression of atherosclerotic heart disease.

    04:07 That's the theory working on right now, and that will minimize the risk of cardiovascular events.

    04:13 But stay tuned.

    04:14 We're doing research and learning new things all the time.

    04:18 Medicine is constantly evolving and that's the cool part, and why you have to stay a lifelong learner.

    04:24 Most of what we discussed about statins is great and they really are good at what we give them for.

    04:30 but I want you to be aware as an excellent nurse, I want you to be aware that there are some rare adverse effects.

    04:36 Two areas that we focus in - hepatotoxicity and myopathy.

    04:42 Hepato- means liver, right and -toxicity means not good for it So statins can be kind of hard on your liver.

    04:50 So you want to watch this closely, the healthcare team will monitor liver function test and creatine kinase levels.

    04:57 So two adverse effects, rare but potential: hepatoxocity and myopathy.

    About the Lecture

    The lecture Repetition of Medications to Lower LDL Cholesterol Levels – Statins (Nursing) by Rhonda Lawes, PhD, RN is from the course Coronary Artery Disease: Atherosclerosis (Nursing) .

    Included Quiz Questions

    1. Statins
    2. Prils
    3. Sartans
    4. Lipases
    1. By increasing LDL receptors in the liver
    2. By decreasing LDL receptors in the liver
    3. By increasing HDL synthesis, which replaces LDL
    4. By binding to LDLs and being excreted through the kidneys
    1. Decreased serum LDL as seen on bloodwork
    2. Patient reports weight loss
    3. Echocardiogram to assess the heart
    4. Increased triglyceride levels as seen on bloodwork

    Author of lecture Repetition of Medications to Lower LDL Cholesterol Levels – Statins (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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