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P A R T 8  Drugs acting on the cardiovascular system

National Heart Foundation (NHF). (2012). Reducing risk in heart disease: An expert guide to clinical practice for secondary prevention of coronary heart disease. www.heartfoundation.org. au/SiteCollectionDocuments/Reducing-risk-in-heart-disease.pdf. Nissen, S. E., Nicholls, S. J., Wolski, K., Rodes-Cabau, J., Cannon, C. P., Deanfield, J. E., et al. (2008). Effect of rimonabant on progression of atherosclerosis in patients with abdominal obesity and coronary artery disease. JAMA, 229 , 1547–1560. Porth, C. M. (2011). Essentials of Pathophysiology: Concepts of Altered Health States (3rd edn). Philadelphia: Lippincott Williams & Wilkins. Porth, C. M. (2009). Pathophysiology: Concepts of Altered Health States (8th edn). Philadelphia: Lippincott Williams & Wilkins.

Schwartz, G., Ander, G. O., Ezekowitz, M. E., Ganz, P., Oliver, M. F., Waters, D., et al. (2001). Effects of atorvastatin in early recurrent ischemic events in acute coronary syndrome. The MIRACL study: A randomized controlled trial. JAMA, 285 , 1711–1718. Smith, J. (2011). Appropriate primary prevention of cardiovascular disease: Does this mean more or less statin use? Australian Prescriber, 34(6) , 169–172. Spinler, S. A. (2006). Challenges associated with metabolic syndrome. Pharmacotherapy, 26, 209S–217S. Zhu, Y. Y., Hayward, P. A., Hare, D. L., Stewart, A. G. & Buxton, B. F. (2012). Lipid management in high risk coronary patients: How effective are we at secondary prevention? Heart, Lung & Circulation, 21(2) , 82–87.

C H E C K Y O U R U N D E R S T A N D I N G

6. Which of the following would the healthcare provider include when teaching a person about HMG-CoA reductase inhibitors? a. The person will not have a heart attack. b. The person will not develop CAD. c. The person might develop cataracts as a result. d. The person might stop absorbing fat-soluble vitamins. 7. Which of the following would the nurse expect the healthcare provider to prescribe for a person who has high lipid levels and cannot take fibrates or HMG-CoA reductase inhibitors? a. nicotine b. vitamin C c. nicotinic acid d. nitrates 8. Which of the following would alert the healthcare provider to suspect that a person receiving HMG-CoA reductase inhibitors is developing rhabdomyolysis? a. flatulence and abdominal bloating b. increased bleeding and bruising c. the development of cataracts and blurred vision d. muscle pain and weakness MULTIPLE RESPONSE Select all that apply. 1. A bile acid sequestrant is a drug of choice for a person who has which of the following? a. a high LDL concentration b. a high triglyceride concentration

Answers to the questions in this chapter can be found in Appendix A the back of this book.

MULTIPLE CHOICE Select the best answer to the following.

1. After describing to a community group the ways in which the body uses cholesterol, which of the following, if stated by the group as a way, indicates successful teaching? a. the production of water-soluble vitamins b. the formation of steroid hormones c. the mineralisation of bones d. the development of dental plaques 2. The formation of atheromas in blood vessels precedes the signs and symptoms of: a. hepatitis. b. coronary artery disease. c. diabetes mellitus. d. chronic obstructive pulmonary disease (COPD). 3. Hyperlipidaemia is considered to be: a. a normal finding in adult males. b. related to stress levels. c. a treatable CAD risk factor. d. a side effect of cigarette smoking. 4. The bile acid sequestrants: a. are absorbed into the liver. b. take several weeks to show an effect. c. have no associated adverse effects. d. prevent bile salts from being reabsorbed. 5. HMG-CoA reductase inhibitors work in the: a. process of bile secretion. b. process of cholesterol formation in the cell. c. intestinal wall to block fat absorption. d. kidney to block fat excretion.

c. biliary obstruction d. vitamin K deficiency e. a high HDL concentration f. intolerance to statins