HMG- CoA Reductase inhibitors

main idea

liver makes less cholesterol by lowering LDL

LDL (low density lipoproteins)

transports cholesterol thru blood to tissues

bad cholesterol

LDL bc too much LDL in blood causes atherosclerotis plaque → risk of heart attack and stroke

HMG-CoA Reductase

converts HMG-CoA into mevalonate, a major rate-limiting step that controls how quickly the liver can make cholesterol

-cholesterol making enzyme

statins

completely blocks HMG-CoA reductase by competitively inhibiting it

-block rate limiting step of cholesterol synthesis

pathway of statins

blocks HMG-CoA reductase → less mevalonate produced → liver makes less cholesterol → liver realizes its cholesterol level is low so it puts more LDL receptors on liver surface → LDL receptors grab LDL from blood → blood LDL decreases

2 effects of statins

liver makes less cholesterol and liver removes more LDL from blood

indications (why would i give this medication)

hyperlipidemia

atherosclerotic

hypercholesterolemia

hyperlipidemia

too much lipids in blood, statins directly lower lipids in blood

atherosclerotic

plaque buildup in arteries, statins lower LDL → less cardiac issues

Hypercholesterolemia

high blood cholesterol, statins lower cholesterol

contraindications of statins

breastfeeding and active liver disease

ADR common of statins

myopathy and diarrhea

myopathy

muscle pain, weakness, and tenderness

ADR rare of statins

rhabdomyolysis and hepatotoxicity

rhabdomyolysis

rare but severe muscle breakdown, extreme version of myopathy

counseling point of statins

contact doctor if you develop muscle pain