Nursing Pharmacology  / Medications: Cardiovascular  /

Pharmacology, part 22.4: Cardiovascular Medications - Fibric Acid Derivatives (Fibrates)

  • 00:00 Intro
  • 00:24 Fibric Acid Derivatives (Fibrates)
  • 1:00 Mode of Action
  • 1:15 Side effects
  • 2:01 Quiz
Cool Chicken Hint:

When you see this Cool Chicken, that indicates one of Cathy's silly mnemonics to help you remember. The Cool Chicken hints in these articles are just a taste of what's available across our Level Up RN Flashcards for nursing students!

In this article, we cover a class of antilipemic medications called fibrates, including a background on cholesterol; and the indication, mode of action, side effects, nursing care and patient teaching for fibrates.

The Nursing Pharmacology video series follows along with our Pharmacology Flashcards, which are intended to help RN and PN nursing students study for nursing school exams, including the ATI, HESI, and NCLEX.

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Gemfibrozil (Lopid) and fenofibrate (Lipidil) are medications used to help lower fats (triglycerides) and raise “good” cholesterol (HDL) in the blood. They belong to a group of drugs known as “fibrates” or fibric acid derivatives.

Cool Chicken Hint:

L for Lethal/Lousy (i.e., bad). H for Happy (i.e., good).

Mode of action

Gemfibrozil and fenofibrate work by decreasing triglyceride production and transport.

Cool Chicken Hint:

Just like eating a lot of fiber, gemfibrozil and fenofibrate
will help decrease your cholesterol.

Side effects

Side effects of gemfibrozil and fenofibrate can include GI upset, gallstones, hepatotoxicity, and muscle pain.

If you've noticed, hepatotoxicity is a possible adverse effect of all of the antilipemic medications we've covered so far in this series. Remembering that cholesterol is synthesized in the liver can help you to remember this as an adverse effect!

Contraindications

Because fibric acid derivatives increase the risk of gallstones, they are usually contraindicated in patients who have existing gallbladder disease

Patient teaching & monitoring

In terms of administration, gemfibrozil is taken twice a day, 30 minutes before breakfast and dinner. Fenofibrate, on the other hand, is taken once a day, and it can be taken with or without meals.

Also, due to the increased risk of hepatotoxicity, it’s important to monitor the patient’s liver function during therapy, which includes their ALT and AST levels.

Quiz Questions

Fibric acid derivatives decrease HDL levels. True or false?
False. They increase levels of HDL, which is the good cholesterol

Why should ALT and AST lab values be monitored during gemfibrozil therapy?
Due to the risk for hepatotoxicity, or liver damage

Why is gemfibrozil contraindicated for patients with gallbladder disease?
Because this medication increases the risk of gallstones

Full Transcript: Pharmacology, part 22.4: Cardiovascular Medications - Fibric Acid Derivatives (Fibrates)

Hi, I'm Cathy with Level Up RN. In this video, I will be discussing fibric acid derivatives. And at the end of the video, I'm going to give you guys a little quiz to test your understanding of some of the key facts I'll be covering, so be sure to stay for that. Fibric acid derivatives are used to treat high cholesterol or hypercholesteremia. Some of the medications that fall within this drug class include gemfibrozil and fenofibrate. And as you can see, both of these drugs have F-I-B or fib in the middle of their names, which will help you to remember that they are fibric acid derivatives. And our cool chicken hint to help you remember what these drugs are used for is just like eating a lot of fiber, gemfibrozil and fenofibrate will help lower your cholesterol. Fibric acid derivatives work by decreasing triglyceride production and transport. They also increase levels of HDL, which is our good cholesterol. So H for HDL and H for happy. Side effects can include gastrointestinal issues such as indigestion and stomach pain, as well as muscle pain. In addition, fibric acid derivatives increase the risk of gallstones, so they are generally contraindicated in patients with existing gallbladder disease. Also, in rare cases, fibric acid derivatives can cause hepatotoxicity or liver damage, so it's going to be important to monitor your patient's liver function throughout therapy, which includes their ALT and AST levels. In terms of administration, gemfibrozil is taken twice a day, 30 minutes before breakfast and dinner. Fenofibrate, on the other hand, is taken once a day, and it can be taken with or without meals.

All right. It's quiz time, and I have three questions for you.

Question number one. Fibric acid derivatives decrease HDL levels. True or false?

The answer is...false. They actually increase levels of HDL, which is our good cholesterol.

Question number two. Why should ALT and AST lab values be monitored during gemfibrozil therapy?

The answer is...due to the risk for hepatotoxicity or liver damage.

And question number three. Why is gemfibrozil contraindicated for patients with gallbladder disease?

The answer is...because this medication increases the risk for gallstones.

All right. That's it for this video. I hope it was helpful. Take care, and thank you so much for watching.

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