Zetia

Erie Community College

Introduction This paper will be discussing the drug Zetia from an article found in The New York Times. It will be comparing and contrasting information from the article, to actual data from a professional resource. Zetia is a drug that is prescribed to about 1 million people a week for the purpose of lowering cholesterol (Berenson, 2008). According to the article, the drug company Merck and Schering-Plough had stated that Zetia has failed to show any medical benefits (Berenson, 2008). The information to be presented is going to be about the drug Zetia (ezetimibe) and Zocor (simvastatin) combined and is called Vytorin.

Discussion Zetia is a newer cholesterol drug that works by blocking the cholesterol in food from crossing the intestinal wall and getting into the bloodstream (Ijioma & Robinson, 2011). Statins prevent cholesterol from being absorbed in the liver, and also reduce inflammation, another cause of cardiovascular disease. Adding Zetia to a statin cuts cholesterol levels much more than just increasing the dose of the statin. Vytorin is a combo pill; it combines simvastatin, which blocks production of cholesterol in the liver, and ezetimibe, which blocks absorption of cholesterol in the intestines (Ijioma & Robinson, 2011). Vytorin is indicated for the reduction of elevated total-C and LDL-C in patients with homozygous familial hypercholesterolemia, as an adjunct to other lipid-lowering treatments or if such treatments are unavailable (RxList, nd). The New York Times and the professional article both talk about the effects of Zetia. The lay article states that Zetia lowers cholesterol by 15 – 20 percent in most patients, but no clinical trial can show that it reduces heart attacks and strokes. It also does not show that it reduces the growth of fatty plaques in arteries that cause heart problems (Berenson, 2008). Yet the professional journal states that Ezetimibe/simvastatin coadministration results in LDL reductions of 34–61%, non-HDL reductions of 41–56%, 6–12% increases in HDL, 19–35% reductions in triglycerides (Ijioma & Robinson, 2011). The lay article goes further to state that instead of reducing the growth of plaques, the plaques actually grew almost twice as fast in patients taking Zetia along with Zocor (Berenson, 2008). Contrary to the lay article, the professional article claims that there was no difference in carotid intima media thickness (a measure of atherosclerosis) with patients on ezetimibe statin therapy over 2 years. However, carotid intima media thickness reduction did occur with the use of extended release niacin (Ijioma & Robinson, 2011). The lay article states that doctors often prescribed Zetia as an additional therapy for patients whose cholesterol remains high even after they are already taking statins (Berenson, 2008).
Implication for Wellness There are many different ways to promote wellness if you are dealing with high cholesterol. The first and foremost thing you need to do is get your cholesterol levels check routinely. Adults are advised to get their levels tested at least once every five years. Many people can lower their risk of heart attack through diet and exercise. Following a healthy diet as in the Mediterranean diet, the dash (Dietary Approaches to Stop Hypertension) diet, and the Ornish Diet (which is particularly low in meat and dairy) are variations on this approach. One study found that a balanced diet did just as well as a statin at reducing bad cholesterol. Regular exercise is also critical. Some studies show that regular aerobic exercise for a period of about 12 weeks can modestly increase beneficial HDL cholesterol—between 5 and 10 percent, and more for some people. Shoot for at least 30 minutes of moderate aerobic exercise five to seven days a week (Brunner & Suddarth’s, 2010).

Conclusion Overall, cholesterol-lowering drugs seem to be some of the most widely prescribed drugs by doctors, who in my opinion, rarely take the time to talk to their patients about lowering cholesterol through diet and lifestyle. Most medical professionals want to hold onto the beliefs that elevated cholesterol is hereditary, which some may be but they still should be talking to patients about the need to make lifestyle changes. I think more people would make the necessary changes if they knew that the risks of taking statin drugs are quite serious.

References

Berenson, A (2008, January 14). Drug has no benefit in trial, makers say. The New York Times.
Nkechinyere, I and Robinson, J.G. (2011). Lipid-lowering effects of ezetimibe and simnvastatin in combination. Expert Rev. Cardiovasc. Ther. 9(2), 131-145.
RxList. (n.d.) In RxList, The Internet Drug Index online. Retrieved from http://www.rxlist.com/vytorin-drug/indications-dosage.htm
Smeltzer, S.C., Bare, B.G., Hinkle, J.L., Cheever, K.H. (2009). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing (12th ed.) Wyoming: Lippincott-Raven Publishers.