The patient tells the nurse that his doctor wants him to take a medication for his high cholesterol, but he doesn't know which one would be best. What is (are) the best response(s) by the nurse?
1. "The best drugs to raise your high density lipoprotein (HDL) levels are the fibric acid drugs."
2. "The statin drugs are good, but will cause a lot of flushing if you swallow them with warm fluids."
3. "The bile resins keep cholesterol from being absorbed, but have some side effects."
4. "The statin drugs inhibit the making of cholesterol and are considered the best choice."
5. "Fibric acid drugs will decrease triglycerides, but your low density lipoprotein (LDL) will still be high."
Correct Answer: 3,4,5
Rationale: Fibric acid agents are effective, but will not reduce low density lipoprotein (LDL) levels. Statin drugs inhibit HMG-CoA reductase which is necessary for the biosynthesis of cholesterol and are the drugs of first choice in reducing serum lipid levels. Bile resins are effective, but numerous side effects limit their usefulness. Niacin, not statins, will cause flushing, which is worse with warm fluids. The best drugs to raise high density lipoprotein (HDL) levels are statins, not fibric acid drugs.
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