Hyperlipidemia monitoring

Hyperlipidemia Diet HMG-CoA reductase inhibitors (stati ns) Gemfibrozil Ezetemibe CSA greater than TAC consider switch to TAC discontinue or hold SRL CSA/TAC may increase statin levels start at lowest dose Monitor for muscle cramps, CPK levels and LFTs Adjust dose in those with Rl Caution with concomitant statin Often used in combination with a statin... 

Many patients treated for primary hyperlipidemia have no symptoms or clinical manifestations of a genetic lipid disorder (e.g., xanthomas), so monitoring is solely laboratory based. 

Patients with hyperlipidemia or hypertension should be monitored to assess the effects of weight loss on appropriate end points. 

Monitoring Pretreatment and annual exams should include blood pressure, breasts, abdomen and pelvic organs, including Papanicolaou smear. Perform preventative measures and screening, which should include total and HDL cholesterol within 5-year intervals. Advise the pathologist of OC therapy when relevant specimens are submitted. Do not prescribe for more than 1 year without another physical exam. Lipid disorders Closely follow women taking OCs who are being treated for hyperlipidemias. 

Monitor patients who are administered sirolimus for hyperlipidemia using laboratory tests. If hyperlipidemia is detected, initiate subsequent interventions such as diet, exercise, and lipid-lowering agents, as outlined by the National Cholesterol Education Program guidelines. 

Hyperlipidemia, dyslipidemia PO 5 to 40 mg/day. Usual starting dosage is 10 mg/day, with adjustments based on lipid levels monitor q2-4wk until desired level is achieved. Maximum 40 mg/day. 

Diagnosis of nephrotic syndrome depends on the identification of both the clinical signs (edema) and laboratory disorders (proteinuria, hypoproteinemia, hypoal-buminemia, hyperlipidemia). Lipid and coagulation abnormalities that also must be monitored are described in detail in the appropriate sections. 

Adverse effects Thiazide diuretics induce hypokalemia and hyperuricemia in 70% of patients, and hyperglycemia in 10% of patients. Serum potassium levels should be monitored closely in patients who are predisposed to cardiac arrhythmias (particularly individuals with left ventricular hypertrophy, ischemic heart disease, or chronic congestive heart failure) and who are concurrently being treated with both thiazide diuretics and digitalis glycosides (see p. 160). Diuretics should be avoided in the treatment of hypertensive diabetics or patients with hyperlipidemia. 

In a study of the safety and efficacy of simvastatin in hyperlipidemia after renal transplantation in 15 patients, the Cmax and AUC of simvastatin were increased seven-fold by ciclosporin (260). In contrast, in 17 patients, tacrolimus had no effect. Although there were no complications, such as myopathy or rhabdomyolysis, creatine kinase activity must be monitored during co-administra-tion of simvastatin and ciclosporin. 

Monitor for hyperlipidemia (elevated blood lipid levels). 

Atypical antipsychotics Monitor for increased appetite with weight gain (primarily in patients with initial low or normal body mass index) monitor closely if rapid or significant weight gain occurs during early therapy cases of hyperlipidemia and diabetes reported. 

At this point, the first therapeutic steps should be nonpharmacologic. Mr. Applebod s obesity should be treated with caloric restriction and a carefully monitored program of exercise. A reduction of dietary fat and sodium would be advised in an effort to correct his hyperlipidemia and his hypertension, respectively. 

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