DRUGS FOR HYPERCHOLESTEROL Introduction The A

The American Heart Association (AHA) (2000) reports that the total blood cholesterol is usually the method of measurement indicating blood cholesterol (milligrams per deciliter of blood, mg/dl). However, absolute numbers for total blood cholesterol and HDL cholesterol levels are more useful for determining appropriate treatment (American Heart Association [AHA], 2000).

AHA also reports on drugs commonly used for treatment of hypercholesterol. First choice of drugs are bile acid sequestrants, cholestyramine, colestipol, and nicotinic acid (niacin). All have been shown to be effective in clinical trials and nicotinic acid is preferable in those with elevated triglyceride levels over 250 mg/dl, since this class of drugs will raise these levels. HMG CoA reductase inhibitors, lovastatin, pravastatin, simvastatin, and fluvastatin are statin drugs that are also considered effective for lowering cholesterol levels; these have only few and immediate short-term side effects. Gemfibrozil, probucol, and clofibrate are used as well, however, only probucol has received FDA approval (AHA; Cobos, Jovell, Garcia-Altes, Garcia-Closas, & Serra-Majem, 1999, p. 1924).

Cholestyramine and colestipol are used to lower cholesterol levels in the blood. They are not absorbed by the body and work by attaching to intestinal substances which are then passed out of the body unabsorbed. Consideration of other medical concerns such as allergies or pregnancy or disea

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higher than the benefit and again, all preexisting medical problems must be considered. Other side effects include: cough, hoarseness, fever/chills, muscle, back, stomach, or side pain, nausea or vomiting, difficult urination, tiredness (rare); rash, diarrhea, nausea, or vomiting (common); and stomach pain, gas, heartburn (more common) (Micromedex, 2000). Probucol lowers cholesterol levels in the blood. Medical conditions are considered before using this drug. Side effects include the following: swollen face, hands, feet or mouth, bleeding or bruising, and tiredness (rare); and fast or irregular heartbeat, dizziness or fainting, headache, numbness or tingling of face, fingers, or toes, bloating, diarrhea, stomach pain with nausea and vomiting (common) (Micromedex, 2000). Clofibrate lowers cholesterol and triglyceride levels in the blood. As with gemfibrozil, this drug may have unwanted side effects. Clofibrate may result in the increased risk of cancer, liver disease, pancreatitis, and gallstones. Additional medical problems would increase concern for drug usage. Other side effects include: irregular heartbeat, chest pain, short breath, cough, hoarseness, stomach pain or indigestion, nausea and vomiting, fever or chil

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