Rosuvastatin Flashcards
Trade name
Crestor
Generic name
Rosuvastatin calcium
Class of drug
Pharmacologic class: HMG-CoA reductase inhibitor
Therapeutic class: Antilipemic (lipid lowering agent)
How administer
P.O. Tablets: 5 mg, 10 mg, 20 mg, 40 mg
Check liver function tests before therapy starts.
• Give with or without food
• Measure lipid levels within 2 to 4 weeks after therapy starts and after titration.
• Know that drug should be used as adjunct to other lipid-lowering treat-ments, such as diet.
Usual dosage
Adults: 5 to 40 mg P.O. daily. Use 40-mg dose only for patients not reaching LDL-C goal with 20 mg.
> Homozygous familial hypercholesterolemia
Adults: 20 mg/day P.O. daily. (Response to therapy should be estimated from preapheresis LDL-C levels.).
> Heterozygous familial hypercholes-terolemia after failure of an adequate trial of diet therapy
Children ages 10 to 17: 5 to 20 mg P.O. daily. Maximum recommended dosage is 20 mg/day. Individualize dosages according to recommended goal of therapy. Make adjustments at intervals of 4 weeks or more.
What is it used for
Selectively and competitively inhibits HMG-CoA reductase, which catalyzes its conversion to the cholesterol precursor mevalonate and thus limits cholesterol synthesis. This action increases high-density lipoprotein level and decreases low-density lipoprotein (LDL) level. Primary prevention of cardiovascular disease; adjunct to diet for hyper-lipidemia, mixed dyslipidemia, hyper-triglyceridemia, primary dysbetal-ipoproteinemia (type III hyperlipoproteinemia); slowing of progression of atherosclerosis
Complications/Precautions
Hypersensitivity to drug or its components
• Active hepatic disease or persistent, unexplained hepatic enzyme elevations
• Women who are pregnant or may become pregnant
• Breastfeeding patients
Precautions
Use cautiously in:
• predisposing factors for myopathy (such as renal impairment, advanced age, hypothyroidism)
• heavy alcohol use or history of chronic liver disease
• hypersensitivity to other HMG-CoA reductase inhibitors (such as fluvas-tatin, simvastatin)
proteinuria and hematuria
• concurrent use of drugs that may decrease levels or activity of endogenous steroid hormones (such as keto-conazole, spironolactone, and cimeti-dine)
• concurrent use of fenofibrate, lipid-modifying doses (1 g/day or more) of niacin, coumarin anticoagulants, protease inhibitors given in combination with ritonavir
• concurrent use of gemfibrozil (avoid use or, if used, don’t exceed 10 mg daily)
• elderly patients
• children younger than age 10 (safety and efficacy not established).
Nursing Considerations
Monitor CK, creatinine, and urine protein levels closely. Also watch for signs and symptoms of rhabdomyolysis with acute renal fail-ure: CK level above 10 times normal limits, muscle ache or weakness, creatinine elevation, and urine protein level beyond trace, accompanied by hematuria. If these findings occur, withhold drug and notify prescriber immediately.
Monitor liver function tests 12
weeks after therapy begins, after dosage increases, and at least semiannually thereafter. Reduce dosage or withdraw drug if ALT or AST persists at three times normal levels.
Temporarily withhold drug in patients with acute, serious conditions predisposing to renal failure caused by rhabdomyolysis (such as sepsis, hypo-tension, major surgery, trauma, uncontrolled seizures, or severe metabolic, endocrine, and electrolyte disorders).
• Monitor blood glucose, electrolyte levels, and lipid panel.
• Assess vital signs and cardiovascular status, especially for tachycardia and palpitations.
• Monitor for signs and symptoms of respiratory tract infection.
• Stay alert for tremor and asthenia.
Adverse effects
CNS: headache, dizziness, anxiety, depression, insomnia, hypertonia, paresthesia, asthenia, tremor, vertigo, neuralgia
CV: palpitations, tachycardia, chest pain, angina pectoris, hypertension, vasodilation, peripheral edema
EENT: rhinitis, sinusitis, pharyngitis
GI: nausea, vomiting, diarrhea, consti-pation, abdominal pain, dyspepsia, flatulence, gastritis, gastroenteritis, pancreatitis
GU: urinary tract infection, myoglo-binuria, acute renal failure
Hepatic: fatal and nonfatal hepatic failure (rare)
Hematologic: anemia
Metabolic: hyperglycemia, diabetes mellitus
Musculoskeletal: myalgia, myopathy, joint pain, rhabdomyolysis Skin: rash, pruritus, urticaria
Other: hypersensitivity reactions (including angioedema)
