Pharmacology Made Easy: HMG-CoA Reductase Inhibitors – Atorvastatin

Flashcards covering the therapeutic uses, adverse reactions, interventions, administration, client instructions, contraindications, precautions, and interactions related to atorvastatin (HMG-CoA Reductase Inhibitors).

What are the therapeutic uses of HMG-CoA Reductase Inhibitors like atorvastatin?

They reduce LDL and triglycerides, increase HDL cholesterol, and reduce the risk/prevent cardiovascular diseases like heart attacks.

What are the main adverse drug reactions associated with atorvastatin?

Myopathy (muscle pain that can lead to rhabdomyolysis) and hepatotoxicity.

What intervention should be taken if a patient on atorvastatin experiences muscle pain?

Monitor for and report myopathy, and measure creatine kinase (CK) if muscle pain occurs periodically.

What lab tests should be monitored periodically for patients on atorvastatin?

Liver function tests should be monitored, and impaired liver function reported.

How should atorvastatin be administered for greatest effectiveness?

It is available orally only and should be taken in the evening with or without food (lovastatin, however, should be taken with food for better absorption).

What important instructions should clients receive regarding muscle pain while taking atorvastatin?

Clients should report any muscle pain to their provider.

What important instructions should clients receive regarding potential liver issues while taking atorvastatin?

Clients should report abdominal pain, jaundice, and fatigue to their provider, and comply with periodic liver function testing.

What are the contraindications for atorvastatin?

Teratogenic effects (not safe for pregnancy or lactation), current liver disease or greatly elevated AST/ALT, and children younger than 8 years of age.

What are some precautions to consider when prescribing atorvastatin?

History of liver disorders, alcohol use disorder, and renal disorders.

What common medication interaction can increase the risk for myopathy or liver toxicity when taking atorvastatin?

Concurrent use of a fibrate or other cholesterol-lowering medication.

What type of medications, when taken concurrently, can increase blood levels of some statins (especially lovastatin and simvastatin)?

Medications that inhibit CYP3A4, such as erythromycin, azole antifungal medications, and HIV protease inhibitors.

What common food item can inhibit CYP3A4 and increase the risk for adverse effects with statins?

Drinking large amounts of grapefruit juice.

What is the risk of concurrent use of warfarin with a statin?

It increases the risk for bleeding and increases prothrombin (PT) and international normalized ratio (INR) levels.