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Flashcards in Lipid Lowering Deck (9):

How do statins work?

Inhibiting HMG-CoA reductase
Inhibits hepatic cholesterol synthesis


Adverse effects of statins

Myopathy: includes myalgia, myositis, rhabdomyolysis and asymptomatic raised creatine kinase
Liver impairment
Intracerebral haemorrhage?


What monitoring should be done with statins?

Check LFTs at baseline, 3 months and 12 months. Treatment should be discontinued if serum transaminase concentrations rise to and persist at 3 times the upper limit of the reference range


What are the risk factors for statin induced myopathy?

Risks factors for myopathy include advanced age, female sex, low body mass index and presence of multisystem disease such as diabetes mellitus.


Who should be given statins?

-All pts with established cardiovascular disease (stroke, TIA, ischaemic heart disease, peripheral arterial disease)
-QRISK2 >10% 10yr cardiovascular risk
-T1DM diagnosed more than 10 years ago OR are aged over 40 OR have established nephropathy


Dose and timing of statins

At night (esp simvastatin)
1º prevention: 20mg atorvastatin OD
2º prevention: 80mg atorvastatin OD


What fruit interacts with statins?

Grapefruit juice


What is lipodystrophy syndrome?

Triad of:
Fat redistribution (buffalo hump)
Insulin resistance
Dyslipidaemia (raised LDL etc)


What drugs increase the risk of statin induced myopathy?

Erythromycin and clarithromycin