Statins Flashcards
what are the drugs used for secondary prevention of CAD and PAD?
Statins
Aspirin
Clopidogrel: antiplatelet
ACE-I
Beta blocker
is there a difference in outcomes of continued use or discontinued of statins after MI
continued use of statins has greater mortality benefit, less ischaemic stroke
3 contraindications to taking statins
having a history of liver disease. regularly drinking large quantities of alcohol. having a history of muscle-related side effects when taking a statin or fibrate (another type of medicine for high cholesterol) having a family history of myopathy or rhabdomyolysis.
how do statins work?
competitively blocking the active site of the first and key rate-limiting enzyme in the mevalonate pathway, HMG-CoA reductas
why should statins not be used with fibrates
raise the risk of myopathy and rhabdomyolysis.
fibrate (gemfibrozil) interferes with statin glucuronidation
may lead to myopathy
drug interactions with statins
PIs
Gemfibrozil
amiodarone
warfarin
calcium channel blockers: amlodipine
tend to increase serum concentration of statins
difference between statins and fibrates
Fibrates change both cholesterol and triglyceride levels
Statins: lower LDL levels, little effect on other lipids
how do fibrates work
Fibrates stimulate cellular fatty acid uptake, conversion to acyl-CoA derivatives, and catabolism by the β-oxidation pathways, which, combined with a reduction in fatty acid and triglyceride synthesis, results in a decrease in VLDL production
which lipid abnormality would benefit the most from fibrates
Hypertriglyceridaemia
why should one be cautious when taking fibrates with warfarin
fenofibrate may increase the effects of warfarin, BLEED
indications for statins
The USPSTF recommends that clinicians prescribe a statin for the primary prevention of CVD for adults aged 40 to 75 years who have 1 or more CVD risk factors (i.e. dyslipidemia, diabetes, hypertension, or smoking) and an estimated 10-year risk of a cardiovascular event of 10% or greater
and secondary prevention?
