Dyslipdemia Meds: Statins-MJ

Question 1

What is dyslipidemia?

Answer 1

Abnormally elevated cholesterol or fat in the blood

Question 2

Is fat dense?

Answer 2

No

Question 3

What is the “good” lipoprotein?

Answer 3

HDL

Question 4

Do we want a high or low level of HDL?

Answer 4

High; HDL cleans out and helps prevent atherosclerosis

Question 5

What causes atherosclerosis?

Answer 5

vLDL and LDL

Question 6

What enzyme do the statins inhibit?

Answer 6

Reductase

Question 7

Since the statins inhibit reductase, what does this do?

Answer 7

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

Question 8

What are the 4 major statins?

Answer 8

Pravastatin
Simvastatin
Atorvastatin
Rousvastatin

Question 9

What is the most common statin (the one that is most prescribed)?

Answer 9

Atorvastatin

Question 10

Statins are the DOC for ______.

Answer 10

Decreasing LDL

Question 11

T/F: Statins are kind of effective in raising HDL.

Answer 11

True

Question 12

T/F: Statins increase vLDL.

Answer 12

False. Statins are kind of effective in lowering vLDL

Question 13

What are the 4 pleiotropic effects that may happen when taking a statin?

Answer 13

1. Stabilizes arterial plaque (so they don’t break off and cause a MI)
2. Anti-inflammatory
3. Anti-oxidant properties
4. Anti-platelet/thrombotic properties

Question 14

What are the 3 adverse effects of taking statins?

Answer 14

1. Muscle pain (myopathy)
2. Hepatoxicity
3. CYP interactions

Question 15

Adverse effects: Myopathy

How many clients are affected by this?

Answer 15

5-10%

Question 16

Adverse effects: Myopathy

What can this progress to? what drug commonly associated with this progression?

Answer 16

Rhabdomyolysis

Rousvastatin is the statin drug primary associated with causing rhabdomyolysis

Question 17

What is rhabdomyolysis?

Answer 17

Muscle disintegration or dissolution

Question 18

What can rhabdomyolysis lead to?

Answer 18

Kidney failure

Question 19

Adverse effects: Myopathy

What do we monitor? and at what level would we need to hold the statin?

Answer 19

Monitor CK levels; hold the statin if CK > 10X the upper limit of normal

Question 20

Adverse effects: Hepatoxicity

How many clients are affected by this?

Answer 20

0.5-2%

Question 21

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?

Answer 21

Baseline LFT; hold if LFT >3X the upper limit of normal

Question 22

Since statins may cause hepatoxicity, is it okay to give it to patients with liver problems?

Answer 22

Depends what liver problem they have

Question 23

Can we give a statin to someone with hepatitis?

Answer 23

No

Question 24

Can we give a statin to someone who has viral or alcoholic hepatitis

Answer 24

No

Question 25

Can we give a statin to someone with nonalcoholic fatty liver disease?

Answer 25

Yes; statins may actually help this liver disease!

Question 26

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.

Answer 26

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

Question 27

Adverse effects: CYP interactions | Out of the 4 statins mentioned, which is the only one that DOES NOT have CYP interactions?

Answer 27

Pravastatin

Question 28

What pregnancy risk category are the statins?

Answer 28

X

Question 29

If a client is taking a statin, what should we tell them to report?

Answer 29

Unexplained muscle pain!

Question 30

When teaching our patient about statins, we should teach them it takes them ____ to work.

Answer 30

2 weeks

Question 31

When teaching our patient about statins, why should we tell them to take the med in the evening?

Answer 31

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)

Question 32

Client teaching: If a patient is on a statin, do they still need to exercise and eat right?

Answer 32

Yes

Question 33

What are the uncommon SE of statins?

Answer 33

Headache, rash, GI disturbances