Atorvastin

Atorvastatin (Lipitor)

Class: HMG-CoA reductase inhibitor.(includes Crestor and Zocor).

•Actions

–Inhibits HMG-CoA, decreases serum cholesterol levels, LDLs, and triglycerides, increases HDL levels. Less cholesterol produced in the liver.

•Indications

–Adjunct to diet in the treatment of elevated cholesterol, triglycerides, and LDL;

–increase HDL-C in individuals with primary hypercholesterolaemia;

–treat familial hypercholesterolaemia and two+ risk factors for CAD

•Adverse Effects

–GI symptoms: flatulence, abdominal pain, cramps, nausea, vomiting and constipation

–CNS: Headache, dizziness, blurred vision, insomnia, fatigue

–Liver failure

–Rhabdomyolosis – muscle wasting

•Drug-to-Drug Interactions

–Erythromycin, cyclosporin, gemfibrozil, niacin

–Digoxin or warfarin

–Oestrogen

–Grapefruit juice

Contraindications: allergy. Active liver disease.

Care considerations: attempt lifestyle changes, avoid dehydration. Hyperlipidaemia -> ^ afterload.

Avoid pregnancy, monitor liver function. Small frequent meals to avoid gi distress. Administer drug at bedtime as the highest rates of cholesterol synthesis occur between midnight and 5 am. Monitor ldl and hdl levels to test effectiveness.

The top 3 drugs are: Lipitor, Zocor, and Crestor.