The Common Side Effects Associated With BAS


Complete this simple chart to help you answer the case study questions. Highlight the correct answers or delete the incorrect answers in each column.

Drug Class Side Effect Best for:
Fibric acid derivatives (fibrates) Muscle aches

Rhabdomyolysis

GI symptoms

Gallstones

Constipation

Increased blood glucose

Headache

Affects warfarin levels

LDL

TG

Pregnancy

Liver disease

CV risk reduction

Bile acid sequestrants (BAS) Muscle aches

Rhabdomyolysis

GI symptoms

Gallstones

Constipation

Increased blood glucose

Headache

Affects warfarin levels

LDL

TG

Pregnancy

Liver disease

CV risk reduction

HMG-CoA reductase inhibitors

(Statins)

Muscle aches

Rhabdomyolysis

GI symptoms

Gallstones

Constipation

Increased blood glucose

Headache

Affects warfarin levels

LDL

TG

Pregnancy

Liver disease

CV risk reduction

Case Information

Mr. Jones, a 65-year-old white male with a history of HTN and diabetes mellitus, has the following lab results:

Lab Results
Total Cholesterol 210 mg/dL
LDL 130 mg/dL
HDL 28 mg/dL
Triglycerides 323 mg/dL

Questions to Answer

Note for students: Type your answers in-line with each question.

What drug class is most important to prescribe for Mr. Jones’ abnormal lipids?

Answer:

If Mr. Jones’ triglycerides were 600, would an additional antilipidemic be indicated? If so, from what drug class? Are these 2 classes okay to combine?

Answer:

What other drug classes would you look for on Mr. Jones’ medication list that can cause elevated triglycerides?

Answer:

How do the three antilipidemic classes work differently? Which can NOT be taken together?

Answer:

What would you teach Mr. Jones about statins?

Answer:

Mr. Jones calls and tells you that he heard from a friend that statins cause muscle aches and that he can no longer take statins if he gets muscle aches. He feels like he might have a few more muscle aches than normal.

Can Mr. Jones still take statins, or does he need to switch to another class of antilipidemics?

Answer:

What labs might you check to confirm whether he is having this side effect?

Answer:

What kind of reassurance can you give Mr. Jones?

Answer:

Answer these additional questions:

What is the difference between a low-intensity, moderate-intensity, and high-intensity statin? What level are most statins?

Answer:

What are the two specific HMG-CoA reductase inhibitor drugs that are considered high potency statins?

Answer:

Which two specific HMG-CoA reductase inhibitor drugs have the least side effects?

Answer:

Which of the antilipemic classes is most effective and recommended as first line treatment by AHA/ACC for most people?

Answer:

Which antilipidemic class is NOT appropriate in pregnancy?

Answer:

For what patients would you consider bile acid sequestrants (BAS)?

Answer:

What are the most common side effects with BAS?

Answer:

References

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