Dyslipdemia Meds: Statins-MJ Flashcards
What is dyslipidemia?
Abnormally elevated cholesterol or fat in the blood
Is fat dense?
No
What is the “good” lipoprotein?
HDL
Do we want a high or low level of HDL?
High; HDL cleans out and helps prevent atherosclerosis
What causes atherosclerosis?
vLDL and LDL
What enzyme do the statins inhibit?
Reductase
Since the statins inhibit reductase, what does this do?
Reductase makes mevalonate, which is what is used to help form cholesterol. If we inhibit reductase by taking a statin, then mevalonate won’t be made and cholesterol won’t be formed
What are the 4 major statins?
Pravastatin
Simvastatin
Atorvastatin
Rousvastatin
What is the most common statin (the one that is most prescribed)?
Atorvastatin
Statins are the DOC for ______.
Decreasing LDL
T/F: Statins are kind of effective in raising HDL.
True
T/F: Statins increase vLDL.
False. Statins are kind of effective in lowering vLDL
What are the 4 pleiotropic effects that may happen when taking a statin?
- Stabilizes arterial plaque (so they don’t break off and cause a MI)
- Anti-inflammatory
- Anti-oxidant properties
- Anti-platelet/thrombotic properties
What are the 3 adverse effects of taking statins?
- Muscle pain (myopathy)
- Hepatoxicity
- CYP interactions
Adverse effects: Myopathy
How many clients are affected by this?
5-10%
Adverse effects: Myopathy
What can this progress to? what drug commonly associated with this progression?
Rhabdomyolysis
Rousvastatin is the statin drug primary associated with causing rhabdomyolysis
What is rhabdomyolysis?
Muscle disintegration or dissolution
What can rhabdomyolysis lead to?
Kidney failure
Adverse effects: Myopathy
What do we monitor? and at what level would we need to hold the statin?
Monitor CK levels; hold the statin if CK > 10X the upper limit of normal
Adverse effects: Hepatoxicity
How many clients are affected by this?
0.5-2%
Adverse effects: Hepatoxicity
What baseline level do we need to take before starting the statin? and at what level would we need to hold it?
Baseline LFT; hold if LFT >3X the upper limit of normal
Since statins may cause hepatoxicity, is it okay to give it to patients with liver problems?
Depends what liver problem they have
Can we give a statin to someone with hepatitis?
No
Can we give a statin to someone who has viral or alcoholic hepatitis
No
Can we give a statin to someone with nonalcoholic fatty liver disease?
Yes; statins may actually help this liver disease!
Explain what this means: No data exist that show that routine periodic monitoring of liver biochemistries is effective in identifying the VERY RARE individual who may develop significant liver injury from ongoing therapy.
Basically, the few people who may get liver disease is probably due to an idiosyncratic effect. Monitoring the liver stats probably would’t have helped catch it
Adverse effects: CYP interactions
Out of the 4 statins mentioned, which is the only one that DOES NOT have CYP interactions?
Pravastatin
What pregnancy risk category are the statins?
X
If a client is taking a statin, what should we tell them to report?
Unexplained muscle pain!
When teaching our patient about statins, we should teach them it takes them ____ to work.
2 weeks
When teaching our patient about statins, why should we tell them to take the med in the evening?
This is when our body makes cholesterol; we want to take the drug when our body is actually making it (to stop the reductase from making mevalonate which makes cholesterol)
Client teaching: If a patient is on a statin, do they still need to exercise and eat right?
Yes
What are the uncommon SE of statins?
Headache, rash, GI disturbances
