Statins

Question 1

how do statins work?

Answer 1

reduce cholesterol production in liver
inhibit HMG CoA reductase

Question 2

When should you check lipids after statins and goal range?

Answer 2

check 3 months = reduce 40% or more of non-HDL cholesterol

Question 3

Important thing to check with pt before increasing statin dose?

Answer 3

check adherence of medication

Question 4

When to check LFTs after starting statins and why?

Answer 4

3 months and 12 months
statins cause mild ALT and AST in first couple weeks

Question 5

Rare and significant side effects of statins?

Answer 5

Myopathy (causing muscle weakness and pain)
Rhabdomyolysis (muscle damage – check the creatine kinase in patients with muscle pain)
Type 2 diabetes
Haemorrhagic strokes (very rarely)

Question 6

Common side effects of statins?

Answer 6

headache and GI upset

Question 7

when to prescribe statins?

Answer 7

• Primary prevention of cardiovascular disease
• Secondary prevention of cardiovascular disease
• Primary hyperlipidaemia

Question 8

Contraindications of statins?

Answer 8

interact- Statins interact with cytochrome P450 inhibitors:
- amiodarone,
- diltiazem,
- itraconazole,
- macrolides
- Clarithromycin/Erythromycin