1. Statins

Question 1

MOA of statins

Answer 1

inhibit the enzyme 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, preventing the conversion to mevalonate (the rate-limiting step in cholesterol synthesis)

Question 2

atorvastatin (brand, generic)

Answer 2

Lipitor

10-80 mg daily

Question 3

fluvastatin (brand, generic)

and specify which is taken in the evening

Answer 3

Lescol, Lescol XL
20-80 mg

Lexcol is taken in the evening

Question 4

lovastatin (brand, generic)

and specify which is taken with the evening mean and which is taken at bedtime

Answer 4

Mevacor (IR), Altoprev (XR)
20-80 mg

Mevacor with evening meal
Altoprev at bedtime

Question 5

pitavastatin (brand, generic)

Answer 5

Livalo

1-4 mg daily

Question 6

pravastatin (brand, generic)

Answer 6

Pravachol 10-80 mg daily

Question 7

rosuvastatin (brand, generic)

Answer 7

Crestor

5-40 mg daily

Question 8

simvastatin (brand, generic)

Answer 8

Zocor

10-40 mg daily in the evening

Question 9

Which statins are taken in the evening?

Answer 9

Lescol, Mevacor (with meal), Altoprev (bedtime), Zocor

Question 10

statin CIs (4)

Answer 10

–active liver disease (including any unexplained elevated LFTs)
–pregnancy, breastfeeding
–concurrent use of strong 3A4 inhibitors (simvastatin and lovastatin)
–concurrent use with cyclosporin (pitavastatin)

Question 11

Risk factors for skeletal muscle effects (4)

Answer 11

–higher concentrations
–advanced age ≥65
–uncontrolled hypothyroidism
–renal impairment