Which administration strategy can a patient implement to reduce flushing, the most common adverse effect of niacin therapy?
Take before starting daily activities.
Take with a sedative.
Take with grapefruit juice.
Take with an NSAID such as ibuprofen.
The Correct Answer is D
Taking niacin with an NSAID such as ibuprofen can reduce flushing, the most common adverse effect of niacin therapy. Flushing is a side effect of taking large doses of niacin (vitamin B3) supplements. It happens when the niacin causes the small blood vessels in your skin to dilate so more blood can rush through. Flushing can cause skin redness, warmth, itching, tingling, or burning sensations.
Choice A is wrong because taking niacin before starting daily activities can increase the risk of flushing and interfere with your routine. Flushing usually occurs within 15 to 30 minutes of taking niacin and lasts for about an hour.
Choice B is wrong because taking niacin with a sedative can increase the risk of liver damage, especially if the sedative is acetaminophen (Tylenol). Niacin can also cause liver problems at high doses, so combining it with another liver-toxic drug is not advisable.
Choice C is wrong because taking niacin with grapefruit juice can increase the risk of side effects, such as low blood pressure, dizziness, or fainting. Grapefruit juice can interfere with the metabolism of some drugs, including niacin, and make them more potent or toxic.
Normal ranges for niacin intake vary depending on age and gender. The recommended dietary allowance (RDA) for adult males is 16 mg per day and for adult females is 14 mg per day. Higher doses of niacin may be prescribed by a doctor to treat high cholesterol or other conditions, but they should be taken under medical supervision and with caution.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
LDL cholesterol is sometimes called “bad” cholesterol because it can build up on the walls of the blood vessels and cause health problems, such as heart disease and stroke.High levels of LDL cholesterol raise your risk for cardiovascular disease. Therefore, decreasing LDL cholesterol levels can lower your risk and improve your health.
Choice A is wrong because increasing LDL cholesterol levels would have the opposite effect of decreasing them.It would increase your risk for cardiovascular disease and plaque buildup in your arteries.
Choice B is wrong because increasing HDL cholesterol levels is not enough to decrease the risk of cardiovascular disease.HDL cholesterol is sometimes called “good” cholesterol because it can move LDL cholesterol from the blood to the liver, where it is broken down and removed from the body.
However, HDL cholesterol levels alone are not a good indicator of your cardiovascular health.You also need to consider your total cholesterol, LDL cholesterol and triglyceride levels.
Choice D is wrong because decreasing HDL cholesterol levels would also increase your risk for cardiovascular disease.HDL cholesterol helps to lower LDL cholesterol levels and protect your blood vessels from plaque buildup.
Therefore, decreasing HDL cholesterol levels would reduce this protective effect and make you more vulnerable to heart disease and stroke.
The ideal ranges for cholesterol levels are as follows:
• Total cholesterol: below 200 mg/dL
• LDL cholesterol: less than 100 mg/dL
• HDL cholesterol: above 40 mg/dL for men and above 50 mg/dL for women
You can lower your LDL cholesterol levels and increase your HDL cholesterol levels by making healthy lifestyle changes, such as eating a balanced diet, exercising regularly, quitting smoking, managing stress and taking medication if prescribed by your doctor.
Correct Answer is A
Explanation
Atorvastatin is a type of statin, which are the most potent antilipidemic agents and have proven to lower the risk of myocardial infarction. Statins work by inhibiting an enzyme called HMG-CoA reductase, which is involved in the synthesis of cholesterol in the liver.By reducing the production of cholesterol, statins lower the levels of low-density lipoprotein (LDL) and triglycerides, and slightly increase the levels of high-density lipoprotein (HDL) in the blood.
Choice B, niacin, is wrong because niacin is not as effective as statins in lowering LDL and preventing cardiovascular events.Niacin is a water-soluble vitamin that can lower LDL and triglycerides, and increase HDL, but it can also cause flushing, itching, and liver toxicity.
Choice C, gemfibrozil, is wrong because gemfibrozil is a type of fibric acid derivative, which are mainly used to lower triglycerides and increase HDL, but have little effect on LDL.
Fibric acid derivatives work by activating a receptor called PPAR-alpha, which regulates the metabolism of lipids in the liver and muscle.Fibric acid derivatives can also increase the risk of gallstones and muscle damage.
Choice D, ezetimibe, is wrong because ezetimibe is a selective cholesterol absorption inhibitor, which blocks the absorption of dietary and biliary cholesterol in the intestine.Ezetimibe can lower LDL by about 15-20%, but it has not been shown to reduce the risk of myocardial infarction on its own.Ezetimibe is usually combined with a statin for better efficacy and safety.
Normal ranges for lipid levels are:
• Total cholesterol: less than 200 mg/dL
• LDL cholesterol: less than 100 mg/dL
• HDL cholesterol: more than 40 mg/dL for men and more than 50 mg/dL for women
• Triglycerides: less than 150 mg/dL
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