7. Why arent bile-acid sequestrants considered first line therapy for dyslipidemia?

Because they tend to cause more frequent side effects than statins.
8. What side effects are associted with use bile acid sequestrants?

They are not absorbed into the systemic circulation, so side effects are limited to the GI tract. (bloating, abdominal pain, nausea, vomiting, diarrhea, steatorrhea and constipation) They can also bind other drugs such as digoxin and warfarin, increasing the potential for drug-drug interactions.
9. Why shouldnt persons having GI obstructions or dysphagia use bile acid sequestrants?

Because they cause constipation and add to the GI motility issues make them worse.
10. What is the administration schedule for bile acid sequestrants?

Medications, vitamins and minerals should be administered more than 1 hour before or 4 hours after the client takes a bile acid sequestrant to prevent decrased absorption of the medicines.
11. Why should vitamin supplements be given to clients using bile acid sequestrants?

Take vitamin suppliments to replace folic acid, fat-soluble vitamins, and vitamin K, because bile acid resins decrease the absorption of vitamins and minterals and can lead to hypokalemia.
12. How does nicotinic acid (Niacin) reduce cholesterol levels?

Nicotinic acid or Niacin decreases VLDL levels, and because LDL is synthesized from VLDL, the client experiences a reduction in LDL levels. It also reduces triglycerides and increases HDL levels.
13. What side effect occurs in almost every client using niacin?

Flushing and hot flashes.

What common therapeutic can mitigate this side effect and what mechanism makes it effective?

Take one aspirin tablet 30 minutes prior to niacin administration can reduce uncomfortable flushing.
14. How do fibric acid agents work to treat dyslipidemia?

Fibric acid agents inhibit the synthesis of triglycerides but have little effect on LDLs. Combining a fibric acid agent with a statin results in greater decreases of triglyceride levels than using either drug alone.
15. How do cholesterol absorption inhibitors differ from bile-acid sequestrants?

Cholesterol absorption inhibitors (ezetimibe Vytorin) block the absorption of cholesterol by cells in the jejunum of the small intestine. Bile acid sequestrants bind bile acids that contain a high concentration of cholesterol and are excreted.
16. Which drug class for lipidemia is most likely to cause gall stones?

Fibric acid agents.

17. What organ function should be regularly monitored with all lipidemic therapies? Liver.