Statin (HMG-CoA reductase inhibitors) Fibrates
Medication: Atorvastatin, Simvastatin, Lovastatin Medication: fenofibrate, gemfibrozil
- PO form only - PO form only
- Greatest time to take is evening with or without food - BID daily, 30 minutes before breakfast and evening meal
- Lovastatin take 1 statin with food to enhance Therapeutic use:
absorption - lower triglycerides
- Increase good cholesterol (HDL) but minimal to no effect
Therapeutic use: First-line therapy for hyperlipidemia on LDL
(high cholesterol) Expected pharmacologic action:
- reduce bad cholesterol (LDL) and triglyceride (LVDL) - Activate PPAR alpha (in the liver and certain adipose
- Increase good cholesterol (HDL) = protect you from tissue) to do two things:
coronary disease by removing bad cholesterol in the 1. Increase enzyme called LPL decrease triglyceride but
blood minimal to no effect on LDL
Expected pharmacological action: statin inhibits HMG- 2. Increase production of lipoproteins and
CoA reductase (enzyme in the liver that is responsible for apolipoproteins A1 and A2 increases HDL
cholesterol synthesis)
Complication:
Complication: - GI effects: Nausea, diarrhea, abdominal pain
- Uncommon: cataract, rash, memory loss, headache, - Risk for gallstones, hepatotoxicity, myopathy (cause
GI disturbance muscle pain)
- Uncommon effects but SERIOUS:
1. muscle pain (myopathy) rhabdomyolysis Nurse should monitor and education client to watch for
(serious condition) & kidney damage and report:
2. hepatotoxicity (jaundice, dark urine, - GI manifestation, any muscle pain
Abdominal pain, N/V, fatigue) - gall bladder disease manifestation like intolerance to
fried foods, upper abdominal discomfort, and bloating
Nurse should monitor and education client to watch - hepatotoxicity signs like jaundice, abdominal pain,
for and report: fatigue
1. Should know it cause more risk for muscle - DON’T GIVE if having gallbladder disease, liver
pain/hepatotoxicity if use with: dysfunction, or severe renal impairments
fibrate and other cholesterol medication - CAN GIVE WITH CAUTION to pregnant, breastfeeding or
, medication that inhibits CYP3A4 pediatric age
(erythromycin, azole antifungal, protease
inhibitors to treat HIV) Lab to monitor and client must comply with LFT q6-
grapefruit juice 12months as prescribed:
2. Should know more risk for bleeding if patient - CK (Creatine kinase) periodically and if muscle pain
takes statin with warfarin Monitor for increased occurs
PT/INR - LFT (Liver function tests) report if impaired liver
3. DO NOT GIVE STATIN: function
during pregnancy and lactation - Lipid panel (cholesterol, LDL, triglyceride, HDL) baseline
teratogenic medication + periodically
patients have elevated liver enzymes
(AST or ALT) indicate liver damage or
active liver disease
Children less than 8y/o
4. USE WITH CAUTION in patient have history of liver
disease, alcoholism or kidney disorder
Lab to monitor and client must comply with LFT q6-
12months as prescribed:
1. CK (Creatine kinase) periodically and if
muscle pain occurs
2. LFT (Liver function tests) report if impaired
liver function
Medication: Atorvastatin, Simvastatin, Lovastatin Medication: fenofibrate, gemfibrozil
- PO form only - PO form only
- Greatest time to take is evening with or without food - BID daily, 30 minutes before breakfast and evening meal
- Lovastatin take 1 statin with food to enhance Therapeutic use:
absorption - lower triglycerides
- Increase good cholesterol (HDL) but minimal to no effect
Therapeutic use: First-line therapy for hyperlipidemia on LDL
(high cholesterol) Expected pharmacologic action:
- reduce bad cholesterol (LDL) and triglyceride (LVDL) - Activate PPAR alpha (in the liver and certain adipose
- Increase good cholesterol (HDL) = protect you from tissue) to do two things:
coronary disease by removing bad cholesterol in the 1. Increase enzyme called LPL decrease triglyceride but
blood minimal to no effect on LDL
Expected pharmacological action: statin inhibits HMG- 2. Increase production of lipoproteins and
CoA reductase (enzyme in the liver that is responsible for apolipoproteins A1 and A2 increases HDL
cholesterol synthesis)
Complication:
Complication: - GI effects: Nausea, diarrhea, abdominal pain
- Uncommon: cataract, rash, memory loss, headache, - Risk for gallstones, hepatotoxicity, myopathy (cause
GI disturbance muscle pain)
- Uncommon effects but SERIOUS:
1. muscle pain (myopathy) rhabdomyolysis Nurse should monitor and education client to watch for
(serious condition) & kidney damage and report:
2. hepatotoxicity (jaundice, dark urine, - GI manifestation, any muscle pain
Abdominal pain, N/V, fatigue) - gall bladder disease manifestation like intolerance to
fried foods, upper abdominal discomfort, and bloating
Nurse should monitor and education client to watch - hepatotoxicity signs like jaundice, abdominal pain,
for and report: fatigue
1. Should know it cause more risk for muscle - DON’T GIVE if having gallbladder disease, liver
pain/hepatotoxicity if use with: dysfunction, or severe renal impairments
fibrate and other cholesterol medication - CAN GIVE WITH CAUTION to pregnant, breastfeeding or
, medication that inhibits CYP3A4 pediatric age
(erythromycin, azole antifungal, protease
inhibitors to treat HIV) Lab to monitor and client must comply with LFT q6-
grapefruit juice 12months as prescribed:
2. Should know more risk for bleeding if patient - CK (Creatine kinase) periodically and if muscle pain
takes statin with warfarin Monitor for increased occurs
PT/INR - LFT (Liver function tests) report if impaired liver
3. DO NOT GIVE STATIN: function
during pregnancy and lactation - Lipid panel (cholesterol, LDL, triglyceride, HDL) baseline
teratogenic medication + periodically
patients have elevated liver enzymes
(AST or ALT) indicate liver damage or
active liver disease
Children less than 8y/o
4. USE WITH CAUTION in patient have history of liver
disease, alcoholism or kidney disorder
Lab to monitor and client must comply with LFT q6-
12months as prescribed:
1. CK (Creatine kinase) periodically and if
muscle pain occurs
2. LFT (Liver function tests) report if impaired
liver function
