Cardiovascular 3 Flashcards
Non modifiable risk factor of CVD
Male
Age
Genetics
Ethnicity
State when a statin is given for the primary prevention of CVD
When Qrisk score is 10% and above
What’s high intensity statin
Statin that will reduce LDL by 40%
Egs of high intensity statin
See bnf
What’s the interaction between statin and fibrates or nicotinic acid
Increase risk of SE eg Rhabdomyolysis
Monitor LF and creatinine kinase
Should statin and Gemfibrozil be used together?
Do not use this combination
Increased risk of rhabdomyolysis considerably
MOA of statin
Acts on HMG COA enzyme involved in the synthesis of cholesterol in the liver
Which statin is safe in pregnancy and BF?
Avoid in pregnancy and BF
Discontinue 3months before attempting to conceive
Patient and carer advice for statin
Advice pt to report promptly unexplained muscle pain, tenderness and weakness
Statin and hepatic impairment
Use with caution
Avoid in active liver disease or when there are unexplained persistent elevations in serum transaminases
Renal and statins
Discontinue if elevated creatinine kinase
Side effects of statins
Muscle toxicity
Which statin can be given at anytime of the day
Atorvastatin
Rosuvastin
Have long duration of action
Dose of atorvastatin for primary prevention of CVd
20mg OD
Dose of atorvastatin for secondary prevention of CVD
80mg OD
What strength of Simvastatin has an MHRA warning
80mg increased risk of rhabdomyolysis
What strength of Simvastatin should be co administered with amlodipine
20mg dose
Higher dose are off label due to side effect of Rhabdomyolysis
Other dose adjustment of statin
See photo
State what to monitor before starting statin
Lipid profile
Liver enzymes
Creatinine kinase
HBA1C or fasting BG
Hypothyroidism
Renal function
State what to monitor after starting statin
Liver enzyme 3 months and 12 months
HBA1C or fasting BG 3 months after starting
