HMG-CoA Reductase Inhibitors

Question 1

HMG-CoA Reductase Inhibitors

Drug Names

Answer 1

Atorvastatin
Lovastatin
Pravastatin
Rosuvastatin
Simvastatin

Question 2

Indications

Answer 2

Along with diet, treats elevated cholesterol, triglycerides, and LDL
Increase in HDL in patients with primary hypercholesterolemia
Treat familial hypercholesterolemia with 2+ risk factors for CAD

Question 3

Mechanism of Action

Answer 3

HMG-CoA reductase (an enzyme) is needed to synthesize cholesterol in the liver. If the enzyme is blocked, serum cholesterol and LDL decrease since the liver cannot produce cholesterol. HDL level increases.

Question 4

Contraindications

Answer 4

Allergy
Pregnancy/lactation (category X)
Acute liver disease or alcoholic liver disease

Question 5

Adverse Effects

Answer 5

GI system: flatulence, abdominal pain, cramps, N/V, constipation
CNS effects: HA, dizziness, blurred vision, insomnia, fatigue, cataracts
Liver: elevated liver enzymes and acute liver failure
Rhabdomyolysis: breakdown of muscles which releases waste products that can injure the glomerulus and result in acute renal failure

Question 6

Drug-Drug Interaction

Answer 6

Erythromycin, cyclosporine, gemfibrozil, niacin, or antifungal drugs
Digoxin or warfarin
Grapefruit juice
Oral contraceptives

Question 7

Assessment

Answer 7

HX: allergy, pregnancy/lactation, liver disease, impaired endocrine function
Physical: CNS, abdomen, vital signs, weight
Labs: renal and hepatic function, lipid levels