16 Statins (HMG-CoA Reductase Inhibitors) Antilipidemics

Statins (HMG-CoA Reductase Inhibitors) example

Atorvastatin (Lipitor)

Statins purpose

lowers LDL, first-line drug

Statins effects on the body

LDL and triglycerides fall, HDL rises a little

Statins indications

high LDL, prevent first or repeat heart attack/stroke, diabetes with high ASCVD risk

Statins coontraindications

active liver disease, alcohol misuse/abuse, pregnancy and breastfeeding, allergy (to statin)

Statins dose and monitoring

• 10 to 80 mg PO once daily, usually in the _____

• Monitor _____ and _____ every 6 months

evening, LFTs, CK

Statin side effects

myalgia (muscle aches), headache, nausea, diarrhea

Statin adverse effects

myopathy, rhabdomyolysis, hepatotoxicity

Statin client education

report muscle pain, weakness, dark urine, yellow skin or eyes; avoid grapefruit and limit alcohol; teratogenic

Statin CJMM recognize cues

Muscle pain, dark urine, CK and liver tests (LFTs)

Statin CJMM analyze cues

Common aching or early rhabdomyolysis?

Statin CJMM prioritize hypothesis

Dark urine plus high CK comes first

Statin CJMM generate solutions

Hold the dose; discuss options with provider

Statin CJMM take actions

Notify provider; teach what to report

Statin CJMM evaluate outcomes

LDL falls; muscle symptoms resolve