Statins

Question 1

Format Counselling a patient on drugs

Answer 1

Athletics 
A - action 
T - timeline (how often)
H - how to take 
L - length of treatment 
E - effects (how long till benefit)
T - tests
I - important side effects 
C - complications and contraindications 
S - supplementary advice

Question 2

Statin: indications

Answer 2

1yr hypercholesterolaemia, 1yr prevent of CVD in high risk patients, 2yr prevention of CV events

Question 3

Statin: action

Answer 3

Stops the liver making cholesterol. Cholesterol is one of the factors that predisposed to artery problems causing heart disease, Stroke and kidney disease.

Works by inhibiting 3-HMG-CoA reductase

Question 4

Statin: timeline

Answer 4

OD in the evening

Question 5

Statin: how to take

Answer 5

Tablet

Question 6

Statin: length of treatment

Answer 6

Lifelong

Consider 10 year benefit /stop start

Question 7

Statin: effects

Answer 7

Decreases risk over many years

Question 8

Statin: tests

Answer 8

LFTs - before starting, 3 months and 12 months (statins cause altered LFTs

Rental function - before starting and at 3 months

Creatinine kinase is muscle pains

Review in 4 months initially then every 6 months

Question 9

Statins: important side effects

Answer 9

Myosotis
Myalgia
Itching
Also nausea, sickness, diarrhoea, Abdominal pain

Rarely - back pain, hyperglycaemia

Question 10

Statins: complications and contraindications

Answer 10

Complications: Rhabdomyolysis

Contraindications: pregnancy

Question 11

Statins: supplementary advice

Answer 11

Avoid grapefruit if taking simvastatin - increases levels of simvastatin in blood and makes more likely to have side effects

Atorvastatin a problem if drink large amounts of grapefruit juice (more that 1.2L)

Can look at BHF website regarding further advice