Statins pharmacology nursing review for NCLEX and nursing school exams. In this video, Nurse Sarah reviews statins (HMG-CoA Reductase Inhibitors), which are antilipemic cholesterol lowering medications.
Hey everyone it’s sarah register nurse rn.com and in this video we’re going to go over statins and this video is part of an nclex review series over pharmacology and as always whenever you get done watching this youtube video you can access the free quiz that will test you on this material so let’s get started suns are used to lower the cholesterol levels in the
Body you may also hear them sometimes referred to as hmg coa reductase inhibitors and that name is going to make sense and it really tells us how these drugs work to lower the cholesterol levels now statins are really easy to identify so when you’re going through a patient’s list all you have to do is look at that suffix of that medication name the generic
Part and you’ll be able to tell if it’s a statin because all these drugs end in statin so we have like for instance simvasatin lovasatin pravasatin etc now what’s the mechanism of action of statins how do they actually lower the cholesterol levels in the body well to help us understand that we have to talk about the liver so our liver is an amazing organ and
It does so much for our body and one of the things it does is it conducts cholesterol synthesis now cholesterol synthesis is a very complex thing that occurs in the liver and it can’t do it successfully without the activation of the mevalonate pathway so the mevalinate pathway is super complex and from a nursing standpoint there’s just a couple things that you
Need to know about it specifically how statins affect it so here i have like a very simplified version of how cholesterol synthesis happens so we start here at our starting point and we have these substances and the main substance i want you to be familiar with is hmg coa so in order for hmg coa to help start this process it needs to turn into mevalonic acid and
It can’t do this unless it has the help of an enzyme called hmg coast reductase and doesn’t that look familiar because that is another name for statins suns are hmg hmg-coa reductase inhibitors so this is where statins are going to work they’re going to inhibit this enzyme from allowing hmg coa to turn into mevalonic acid because whenever we get mevolonic acid
On board that starts the whole mevalinate pathway and then we get the synthesis of cholesterol and whenever we inhibit this what’s it going to do it’s going to help lower our cholesterol levels now why is cholesterol bad why do we want to lower in the blood well the thing is we don’t want to lower all types of cholesterol in the blood some of it’s actually very
Helpful but what we do want to lower is the ldl ldl stands for low density lipoprotein and i want you to remember the l that stands for low because it’s going to help you with remembering what results it should be so this is really considered the bad cholesterol because this substance likes to get in the blood and stick on our vessel walls and it can accumulate
On those walls and turn into fatty plaques and this is termed atherosclerosis and what happens is as these fatty plaques grow they can rupture and they can impede blood flow to whatever structure they’re perfusing so we really don’t want these fatty plaques in our heart because it can cause a heart attack because you’ll have decreased blood flow to the heart muscle
And we really don’t want them in the brain because it can decrease blood flow to the brain and cause a stroke so generally we want that number less so low less than 100 milligrams per deciliter then on the flip side we have hdl and this is known as the good cholesterol and hdl stands for high density lipoprotein and we like this number high because the substance
Is actually very helpful in the blood what it does is it will actually help remove this ldl this bad cholesterol so it doesn’t have a chance to stick to those vessel walls so we like that number generally greater than 60 milligrams per deciliter so how statins are really going to work in a nutshell is that it’s going to hinder this cholesterol synthesis process
Whenever this happens the liver understands that and it’s like oh okay so what we’re going to do is we’re going to increase the number of ldl receptors and what that’s going to do is it’s going to help further drop that ldl level which is good and it actually helps increase the hdl levels so the hdl just as i said it’s going to help remove the ldl so we’ll help
Decrease those levels even more and we can get a decreased total cholesterol level now what conditions are statins used to treat well we know statins lower the cholesterol in the blood so they can be useful in treating patients who have high cholesterol levels because it’s going to help lower the ldl increase the hdl and lower that total cholesterol level also it
Can be used as preventative treatment for patients who have those certain risk factors for developing coronary artery disease related to atherosclerosis plus it can also be used in patients who do have active coronary artery disease to help stabilize those fatty plaques that are within their vessels so they don’t rupture and lead to like a heart attack or stroke
Now let’s wrap up this review and let’s talk about the nurse’s role for a patient who is taking a statin and to help us remember that important information we need to know as nurses let’s remember the word statin so s for sore muscles you want to ask your patient are you having sore muscles or muscle weakness now with statins this is a risk that this can develop
And they think that this is because statins may decrease the amount of coenzyme q10 in the body and this enzyme creates muscle cell energy so you want to ask your patient about that and the physician will probably want to monitor their creatine kinase level now why would they want to monitor this well creatine kinase is a protein found in skeletal muscle and in
The heart so if we have high levels of that in the blood that tells us that our skeletal muscles are becoming damaged and we’d really want to stop this medication if the levels are getting higher than 10 times the upper limit because this could progress to a very serious condition known as statin-induced rhabdomyolysis now what is this well this is a condition
Where the skeletal muscles are becoming very damaged and what’s happening is that myoglobin is being leaked from those muscles into the blood and we know that the kidneys filter our blood and we don’t want myoglobin going to our kidneys because it can lead to kidney failure among other things now there is an increased risk of patients developing this condition
If they’re taking other drugs such as fibrates these are also known as fibric acid derivatives and we’re talking about drugs like pheno fibre or gem fibrazil next is t for toxicity increase with grapefruit consumption so you’d want to tell your patient they want to avoid consuming grapefruit or grapefruit juice because this actually increases the toxicity of
Statins then we have a for alt ast monitored and these are liver enzymes that we’re going to monitor regularly on a patient who is taking a statin because liver failure can occur next t for therapeutic effects so as a nurse you want to be familiar with how statins affect those cholesterol levels and be able to educate your patient on how it affects their ldl
Hdl total cholesterol etc so again just to recap satin should lower the low density lipoprotein the ldl that bad cholesterol and they should increase the hdl slightly they’ll increase it the high density lipoprotein and it’s going to lower the total cholesterol along with helping lower those triglycerides as well but mainly it’s going to help with that ldl then
We have eye for increased glucose in patients at risk for type 2 diabetes so you want to monitor the blood sugar teach the patient that as well teach them of those signs and symptoms for hyperglycemia because if they do have those risk factors for type 2 diabetes it could increase their glucose level and then lastly we have n not a cure statin medications are
Not a cure for high cholesterol levels so you want to tell your patients this and tell them it’s very important they continue with exercise and a healthy diet because i have actually had patients tell me you know i can eat all the fried food i want and i really don’t have to exercise because my cholesterol pill will take care of that and that’s not the case so
We really want to educate patients and inform them that this medication is not a cure okay so that wraps up this review over statins and don’t forget to check out the other videos in this pharmacology series and to access the free quiz that will test you on this content
Transcribed from video
Statins Pharmacology Nursing NCLEX HMG-CoA Reductase Inhibitors Antilipemic Cholesterol Lowering By RegisteredNurseRN
