| Drug and Dosage | Use | Action | Assessment: Side Effects |
|---|
| Atorvastatin calcium (Lipitor)—PO 10 mg daily up to 80 mg/day | Reduce: low-density lipoprotein (LDL), cholesterol, triglycerides | Increases number of hepatic LDL receptors | Back pain, myalgia; constipation, diarrhea; ↑ liver function tests |
| NURSING IMPLICATIONS: Assess for: muscle pain, tenderness, or weakness—check creatine phosphokinase (CPK) level. Use cautiously with: antifungals, niacin, erythromycin |
| Cholestyramine (Questran)—PO 4 gm 1–4 times/day | Hypercholesterolemia; pruritus from increased bile | Binds bile acids in GI tract, increased clearance of cholesterol | Nausea, constipation, abdominal discomfort |
| NURSING IMPLICATIONS: Take before meals; do not take with other medications; give others 1 hr before or 4–6 hr after |
| Gemfibrozil (Lopid)—PO 1,200 mg/day | Hypercholesterolemia | May inhibit peripheral lipolysis and reduce triglyceride synthesis in liver | GI upset (abdominal pain, epigastric pain, diarrhea, nausea, vomiting); rash; headache, dizziness, blurred vision |
| NURSING IMPLICATIONS: Use caution when driving or doing tasks requiring alertness; take before meals |
| Niacin (vitamin B3, nicotinic acid)—PO 1.5–6.0 gm | Hypercholesterolemia | Decreases liver’s production of LDLs and synthesis of triglycerides | GI upset, flushing; pruritus, hyperuricemia, hyperglycemia |
| NURSING IMPLICATIONS: Take the drug with meals; prevent flushing by taking an aspirin 30 min before ; monitor closely during first year of therapy |
| Simvastatin (Zocor)—PO 10–20 mg daily | Lipid-lowering | Inhibits enzyme responsible for increased synthesis of cholesterol | Abdominal cramps, constipation, diarrhea, flatus; heartburn; elevation of liver enzymes, pancreatitis |
| NURSING IMPLICATIONS: Give once in the evening with or without food |