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Heiman.pharm.vascev1
Statins
| Question | Answer |
|---|---|
| Effects | Decreased LDL 18-55%. Increased HDL 5-15%. Decreased triglycerides 7-30%. Decreased levels of C-reactive protein. Improved endothelial function at the site of coronary plaque. Inhibition of platelet aggregation. |
| Kinetics | Large first pass effect. Largely protein bound. CYP 450 metabolism. Mostly excreted in feces. Onset of activity 2 weeks. Maximal effect in 4 to 6 weeks. |
| Adverse Effects | Fatigue. Rash. Cough. Chest pain. Nausea, vomiting. Abdominal pain. Flatulence. Anemia. Headache, dizziness. Progression of cataracts. Gynecomastia. Sun sensitivity. Rhabdomyolysis, arthralgia, myalgia. Increased LFTs, hepatitis, jaundice. |
| Monitoring | Liver function tests Baseline 6 week after initiation 12 weeks after initiation q3months for a year then annually If AST or ALT become three times upper limit or greater, need to decrease dose or discontinue Fasting lipid profile |
| Names | Atorvastatin (Lipitor). Lovastatin (Mevacor). Fluvastatin (Lescol). Pravastatin (Pravachol) Simvastatin (Zocor) Rosuvastatin (Crestor) Pitavastatin (Livalo) |