The home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dl/ The client is taking cholestyramine. Which statement by the client indicates a need for further teaching:___________.1. Constipation and bloating might be a problem.2. I will continue to watch my diet and continue to reduce fats.3. Walking a mile each day will help to solve the process.4. I will continue my nicotinic acid from the health food store.

Further teaching is needed because of drug interaction between cholestyramine and nicotinic acid. Cholestyramine prevent full absorption of Nicotinic acid, therefore continuous intake of this will over load the liver, causing liver damage.

In addition, interaction of the two drugs may lead to liver damage, because nicotinic acids inhibit enzyme for cholesterol synthesis in the liver and aid withdrawal of the deposited cholesterol from the blood,Cholestyramine also works on the liver to remove low -density lipoprotein while increasing levels of high density lipo-protein.Thus putting further strain on the liver.

However, the nurse should summarise that; if the you wish to continue to take nicotinic acid,it should be under the prescription; Cholestyramine should be taken 4-6hrs before or after taken nicotinic acid, although not recommended.

This interaction may also lead to glucose intolerance.