Mrs. Morris’ physician has decided to prescribe an ACE
inhibitor and an HMG-CoA reductase inhibitor (Zocor)....
Mrs. Morris’ physician has decided to prescribe an ACE
inhibitor and an HMG-CoA reductase inhibitor (Zocor).Mrs. Morris’ labs have improved a little bit between 6/25
and 3/15, what would you attribute to Zocor use?
Solutions
Expert Solution
Simvastatin is utilized alongside an appropriate eating routine
to help bring down "terrible" cholesterol and fats, (for example,
LDL, triglycerides) and raise "great" cholesterol (HDL) in the
blood. It has a place with a gathering of medications known as
"statins." It works by decreasing the measure of cholesterol made
by the liver. Bringing down "awful" cholesterol and triglycerides
and raising "great" cholesterol diminishes the danger of coronary
illness and avoids strokes and heart assaults.
Notwithstanding eating a legitimate eating routine, (for
example, a low-cholesterol/low-fat eating regimen), other way of
life changes that may enable this drug to work better incorporate
working out, getting in shape if overweight, and halting
smoking.
Statins diminish cholesterol levels in your blood by hindering
a chemical expected to make cholesterol, and additionally expanding
the quantity of low-thickness lipoprotein (LDL or "terrible"
cholesterol) receptors in the liver, so the liver can process a
greater amount of the LDL found in your blood.
By bringing down cholesterol, statins help to keep the
development of plaque in veins, which can prompt atherosclerosis
(solidifying of the courses), coronary illness, and stroke.
Statins are utilized to help anticipate coronary illness in the
individuals who don't have it however are in danger, and in the
individuals who have just had some type of cardiovascular malady,
for example, a stroke or heart assault.
In patients with coronary illness, diabetes, fringe vascular
malady, or history ofstroke or other cerebrovascular sickness,
simvastatin is recommended for diminishing the danger of mortality
by lessening passing from coronary illness, decreasing nonfatal
myocardial infarction(heart assault) and stroke, and decreasing the
requirement for coronary and noncoronary revascularization
methodology.
1. List the select prototype medication for the
HMG-CoA reductase inhibitors (statins).2. Describe myopathy. List the nursing actions and
client education regarding myopathy.3. Heparin is the select prototype medication for
parenteral anticoagulants. List 2 complications of heparin and give
at least 2 nursing actions for each complication.4. What are the therapeutic uses for the oral
anticoagulant warfarin?5. What are the therapeutic uses for
Dabigatran?
All of the following enzymes catalyze a committed step
except:
A. HMG-CoA reductase
B. Acetyl-CoA carboxylase
C. Fattyacyl-CoA synthetase
D. Pyruvate dehydrogenase complex
E. All of the above enzymes catalyze a committed step
1. List the select prototype medication for the
HMG-CoA reductase inhibitors (statins). There is only one prototype
drug for this class.
2. Describe myopathy. List the nursing actions and
client education regarding myopathy.
3. Heparin is the select prototype medication for
parenteral anticoagulants. List 2 complications of heparin and give
at least 2 nursing actions for each complication.
4. What are the therapeutic uses for the oral
anticoagulant warfarin?
5. What are the therapeutic uses for
Dabigatran?
HMG-CoA reductase is a highly regulated enzyme. Identify three
distinct mechanisms by which this enzyme is regulated. For each,
describe the triggering event and its outcomes on HMGR levels or
activity.
Why is HMG-CoA reductase a target in attempts to lower plasma
cholesterol levels and explain how lovastatin and cholestyramine
work to lower blood cholesterol levels?
Statin drugs, like Mevacor (lovastatin) and Lipitor
(atorvastatin), act as competitive inhibitors of HMG-CoA reductase
by mimicking the structure of mevalonate. However, it is not this
inhibition that directly lowers cholesterol levels in the
blood.
A) What enzymatic reaction does HMG CoA-reductase catalyze? What
is important about this step of cholesterol synthesis?
B) How can statins mechanistically cause a decrease in LDL
cholesterol in the blood if it is not a direct effect of decreased
cellular cholesterol synthesis?
There are four general classes of lipid-lowering drugs: niacin,
fibric-acid derivatives, bile-acid sequestrants, and HMG-CoA
reductase inhibitors.
Describe the pharmacodynamics, pharmacokinetics, and
pharmacotherapeutics of each drug. When, specifically, do you use
each drug? Include monitoring parameters and patient education.
Angiotensin-converting enzyme (ACE) inhibitor drug enalaprilat
is used to treat hypertension and has poor oral bioavailability as
well as a short half-life. What functional groups and properties of
the drug may be responsible for these drawbacks and what can be
done to modify the structure to improve both oral bioavailability
and half-life?