Drug of the Day: Atorvastatin

Question 1

What is the trade name for Atorvastatin?

Answer 1

Lipitor

Question 2

What is the drug class for atorvastatin?

Answer 2

HMG-CoA reductase inhibitor

Question 3

What is the primary indication for atorvastastin?

Answer 3

hyperlipidemia

Question 4

What is the mechanism of action for atorvastatin?

Answer 4

inhibits HMG-CoA reductase (3-hydroxyl-3-methylglutaryl coenzyme A)

Question 5

In the mechanism of action for atorvastatin, what is HMG-CoA?

Answer 5

the rate limiting enzyme in cholesterol production

Question 6

When atorvastatin inhibits HMG-CoA reductase, what 3 things occur?

Answer 6

1. the production of mevalonic acid is reduced
2. increase in LDL receptors on hepatocytes
3. stimulation of LDL catabolism

Question 7

What are the more frequent key adverse effects of taking atorvastatin?

Answer 7

GI effects:

constipation

diarrhea

gas

heartburn

stomach pain

Question 8

What are the less frequent or rare key adverse effects of taking atorvastatin?

Answer 8

impotence (erectile dysfunction)

insomnia

myositis (inflammation of muscles)

rhabodmyolysis (damaged skeletal striated muscle breaks down rapidly)

Question 9

What are the types of monitoring parameters for atorvastatin?

Answer 9

1. Baseline CPK (creatine phosphokinase)
2. Liver function tests (ALT/AST)
   * the ratio between the concentrations of the enzymes aspartate transaminase (AST) and alanine transaminase (ALT) in the blood. It is measured with a blood test and is useful in medical diagnosis to differentiate between causes of liver damage, or hepatotoxicity.*
3. Lipid panel (total cholesterol, LDL, HDL, triglycerides)

Question 10

What are the 4 key patient counseling points for Atorvastatin?

Answer 10

1. take at the same time each day
2. if you miss a dose, do not double up
3. importance of diet in the control of hyperlipidemia
4. do not take with grapefruit juice

Question 11

For primary prevention, what is the dosing for atorvastatin?

Answer 11

10-20 mg po qd

(adust in increments of 10-20 mg every 2-4 weeks)

up to 80 mg po qd max

Question 12

For primary prevention when using atorvastatin, the recommended dosing is an initial dose of _____ for patients requiring more than 45% reduction in LDL.

Answer 12

40 mg po qd

Question 13

For secondary prevention, the dosing for atorvastatin is an initial dose of ____.

Answer 13

80 mg po qd

Question 14

It is necessary to adjust the dosing of atorvastatin for patients with renal insufficiency?

Answer 14

NO

Question 15

Atorvastatin is contraindicated for use in patients with _____?

Answer 15

active liver disease