STATIN ANTIHYPERLIPIDEMIC CHAPTER 43

Question 1

Which of the following drugs is an Statin- Antihyperlipidemic?

A. Atorvastin
B. Digoxin
C. Cilostazol
D. Cyclobenzaprine

Answer 1

A. Atorvastatin

Question 2

What is Atorvastin used to treat?

Answer 2

HMG CoA reductase inhibitors

(Statins)
 Uses
 treat Hyperlipidemia (high cholesterol)

 Action
 Inhibit the enzyme HMG CoA reductase in cholesterol
biosynthesis
 Decreases LDLs, increases HDLs
 Abrupt discontinuation may lead to rebound
effect
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Question 3

What is the subclass of Atorvastin?

A. HMG CoA reductase inhibitors
B. Nicotinic acid
C. Bile-acid sequestrants
D Nitrate

Answer 3

A. HMG CoA reductase inhibitors

Question 4

Side effect of Atorvastin

Answer 4

Rare to have side effects
* GI issues, headache
* Photosensitivity

Dizziness, insomnia, memory impairment, flushing, nightmares, blurred vision, weakness, myalgia, dyspepsia, nausea, diarrhea, flatulence, abdominal pain, peripheral neuropathy

Question 5

Adverse effect of Atorvastin

Answer 5

Rhabdomyolysis (rare), tendon rupture hyperglycemia, diabetes mellitus,Life-threatening: Hepatic/renal failure, stroke, leukopenia, hemolytic anemia, thrombocytopenia

Cataracts
 Liver impairment
 Hyperglycemia
 Rhabdomyolysis (skeletal muscle disorder)

Question 6

Containindication of Atorvastin

Answer 6

Hepatic disease/encephalopathy, cholestasis, pregnancy, breastfeedingCaution: Alcohol use disorder, diabetes mellitus, seizures, renal impairment, stroke, hypotension, hypothyroidism, electrolyte imbalance, rhabdomyolysis, older adults

Contraindications
 Active liver disease
 Pregnant
 Caution
 History of liver disease
 Alcohol use

Question 7

Should you use Atorvastin with a patient who has liver disease?

A. Yes
B. No

Answer 7

B. No

Contraindications
 Active liver disease
 Pregnant
 Caution
 History of liver disease
 Alcohol use
 Interactions
 Antacids

Question 8

What should you assess first before administering Atorvastin?

Answer 8

Assessment
 Assess vital signs and baseline serum cholesterol
levels
 Liver function
 Obtain a medical history/medication history
 Pregnancy test
ASSESS FOR MUSCLE WEAKNESS, MAILAISE, FEVER ARE SIGNS OF TOXICITY AND RHADOMYOSIS

Question 9

NURSING INTERVENTION FOR ATORVASTATIN

Answer 9

Report unexplained muscle tenderness, weakness,
fever and malaise = Rhabdomyolysis (skeletal muscle disorder) MUSCLE WEAKNESS, FEVER,

Question 10

Will Atorvastin lower cholesterol in a day?

Answer 10

Inform patient that it may take several weeks or
months before blood lipid levels decline, and
importance of compliance

Question 11

Patient Education and Teaching

Answer 11

Nursing interventions/Teaching
 Monitor the patient’s blood lipid levels, liver function.
 Observe for signs and symptoms of GI upset.
 Report unexplained muscle tenderness, weakness,
fever and malaise
 Inform patient that it may take several weeks or
months before blood lipid levels decline, and
importance of compliance
 Take at bedtime
 Diet – low fat/low cholesterol
 Instruct patient to have annual eye examinations and
report changes in visual acuity.
 Do not stop abruptly

Question 12

Nonpharmacologic methods to reduce hyperlipidemia?

Answer 12

Nonpharmacologic Methods for
Cholesterol Reduction
 Reduce saturated fats and cholesterol in diet
 Reduce total fat intake to 30% or less of caloric
intake
 Reduce cholesterol intake to 300 mg/day or less
 Exercise
 Stop smoking

Question 13

5. A patient is taking lovastatin. Which serum level is most important for the nurse to monitor?
   a. Blood urea nitrogen
   b. Complete blood count
   c. Cardiac enzymes
   d. Hepatic enzymes

Answer 13

d. Hepatic enzymes

Question 14

6. For what severe skeletal muscle adverse reaction should the nurse observe in a patient taking rosuvastatin?
   a. Myasthenia gravis
   b. Rhabdomyolysis
   c. Dyskinesia
   d. Agranulocytosis

Answer 14

b. Rhabdomyolysis

Question 15

A patient begins taking Atorvastin to treat hyperlipidemia. The patient reports abdominal discomfort and constipation. The nurse will provide which instruction to the patient?
a. Increase fluid intake and slowly increase fiber intake.
b. Stop taking the medication immediately.
c. Take an over-the-counter laxative.
d. Take the medication on an empty stomach.

Answer 15

a. Increase fluid intake and slowly increase fiber intake.

Cholestyramine can cause gastrointestinal upset and constipation, and these symptoms can be reduced with increased fluids and foods high in fiber. Stopping the medication is not indicated. Over-the-counter laxatives are not recommended until other methods have been tried. Giving the medication on an empty stomach will not relieve the discomfort.

Question 16

7. A patient has been taking atorvastatin (Lipitor) for several months to treat hyperlipidemia. The patient reports severe muscle weakness and tenderness. The nurse will counsel the patient to do which of the following?

a. ask the provider about switching to simvastatin.
b. contact the provider to report these symptoms.
c. start taking ibuprofen to combat these effects.
d. stop taking the medication immediately.

Answer 16

b. contact the provider to report these symptoms.

ANS: B
Patients taking statins should report immediately any muscle aches or weakness, which can lead to rhabdomyolysis, a muscle disintegration that can become fatal. All statins carry this risk, so changing to another statin is not indicated. Ibuprofen may be useful, but notifying the provider is essential. Patients should not abruptly discontinue statins without discussing this with the provider.

Question 17

8. The nurse provides teaching to a patient who will begin taking simvastatin Atorvastin to treat hyperlipidemia. Which statement by the patient indicates understanding of the teaching?

A. “I may have diarrhea as a result of taking this medication.”
B.
”I may stop taking this medication when my lipid levels are normal.”
C. “I will need an annual eye examination while taking this medication.”
D.
”I will increase my intake of vitamins A, D, and E while taking this medication.

Answer 17

,ANS: C
The statins can affect visual acuity, so patients should be counseled to have annual eye examinations for assessment of cataract formation. The bile acid sequestrants, not statins, cause diarrhea. Statin drug therapy is lifelong or until behavioral changes prove equally effective (uncommon). Bile acid sequestrants, not statins, decrease the absorption of fat-soluble vitamins.