Therapeutic care of lipid disorders ch 49 Flashcards
For statins identify the prototype drug and explain its mechanism of action, therapeutic effects, and important adverse effects.
Statins Mechanism of Action
Primary Indication:
Atorvastatin is used to treat hypercholesterolemia (high cholesterol).
Mechanism of Action:
It works by inhibiting HMG-CoA reductase, the enzyme responsible for cholesterol production in the liver.
Liver Response:
Reduced cholesterol production prompts the liver to create more LDL receptors on its cells.
Effect on LDL:
Increased LDL receptors lead to greater removal of LDL (bad cholesterol) from the blood.
Therapeutic Outcome:
Blood levels of LDL and total cholesterol are reduced.
Time Frame:
At least 2 weeks of therapy are needed to see these effects.
Therapeutic Effects
Lowers LDL cholesterol: Reduces “bad” cholesterol, which is a major risk factor for atherosclerosis and cardiovascular disease.
Increases HDL cholesterol: Raises “good” cholesterol, which helps remove LDL from the arteries.
Reduces triglycerides: Lowers levels of fats in the blood.
Stabilizes plaques: Reduces inflammation and stabilizes atherosclerotic plaques, lowering the risk of rupture and cardiovascular events (e.g., heart attack, stroke).
Important Adverse Effects
Key Points to Memorize:
Adverse Effects:
Mild GI issues (cramping, diarrhea, constipation).
Rare liver damage (monitor liver function early in therapy).
Drug Interactions:
Increases levels of digoxin, norethindrone, and ethinyl estradiol.
Erythromycin raises atorvastatin levels by 40%.
Grapefruit juice inhibits statin metabolism, risking toxicity.
CoQ10:
Statins reduce coenzyme Q10; supplements may help.
Key Considerations
Monitoring: Regular liver function tests and monitoring for muscle symptoms.
Drug interactions: Risk of myopathy increases with drugs like fibrates or macrolide antibiotics.
Contraindications: Avoid in active liver disease or pregnancy.
