statins Flashcards
What enzyme do statins inhibit?
HMG-CoA reductase
What are the adverse effects of statins?
- Myopathy
- Liver impairment
- Increased risk of intracerebral haemorrhage
What does myopathy include?
- Myalgia
- Myositis
- Rhabdomyolysis
- Asymptomatic raised creatine kinase
What are risk factors for myopathy?
- Advanced age
- Female sex
- Low body mass index
- Presence of multisystem disease such as diabetes mellitus
Which statins are more likely to cause myopathy?
Lipophilic statins (e.g., simvastatin, atorvastatin)
What should be checked according to the 2014 NICE guidelines for liver impairment?
Liver function tests (LFTs) at baseline, 3 months, and 12 months
When should treatment with statins be discontinued due to liver impairment?
If serum transaminase concentrations rise to and persist at 3 times the upper limit of the reference range
Who should avoid statins according to the Royal College of Physicians?
Patients with a history of intracerebral haemorrhage
What are important contraindications for statins?
- Macrolides (e.g., erythromycin, clarithromycin)
- Pregnancy
Who should receive a statin?
- All people with established cardiovascular disease
- Anyone with a 10-year cardiovascular risk >= 10%
- Patients with type 2 diabetes mellitus
- Patients with type 1 diabetes mellitus diagnosed >10 years ago, aged >40, or with established nephropathy
When should statins be taken for optimal effect?
At night
What is the recommended dose of atorvastatin for primary prevention?
20mg
What should be done if non-HDL has not reduced for >= 40%?
Increase the dose of atorvastatin
What is the recommended dose of atorvastatin for secondary prevention?
80mg
Fill in the blank: Statins inhibit the action of _______.
HMG-CoA reductase
True or False: Myopathy is more common in hydrophilic statins.
False
