Pharmacology 215

Which parameters are expected to decrease with statins?

Triglycerides Total cholesterol Apolipoprotein B-100 Low-density lipoprotein (LDL) cholesterol

Which patients would a nurse determine can safely receive treatment with a statin in the absence of any other factors?

A 48-year-old patient with hyperthyroidism A 55-year-old patient with type 2 diabetes mellitus

An obese 84-year-old patient is taking simvastatin 10 mg PO each evening. In addition to dyslipidemia, the patient has hypertension, diabetes, and hypothyroidism. Which factors increase this patient's risk for rhabdomyolysis?

Advanced age Hypothyroidism

A 51-year-old male patient has been prescribed lovastatin 40 mg PO each evening to help lower his low-density lipoprotein (LDL) cholesterol. In addition to lovastatin, this patient also takes pantoprazole for gastroesophageal reflux disease (GERD), amiodarone for atrial fibrillation, tamsulosin for benign prostatic hyperplasia, and lisinopril for hypertension. Which medication could cause a potential drug interaction with lovastatin?

Amiodarone

A patient taking atorvastatin is experiencing the adverse effect of myositis. Which manifestations would a nurse expect to see in this patient?

Creatine kinase (CK) elevation Muscle inflammation Muscle pain

A patient who has received a prescription for lovastatin asks the nurse why grapefruit and grapefruit juice should ideally be avoided. Which explanation would the nurse provide?

Increases risk for rhabdomyolysis

Which statins are significantly metabolized by CYP3A4?

Lovastatin Simvastatin Atorvastatin

An insurance company is requiring a patient receiving pitavastatin 2 mg to switch to another statin to receive coverage. Which statins and doses are therapeutically equivalent to pitavastatin 2 mg?

Pravastatin 40 mg Simvastatin 20 mg Rosuvastatin 5 mg

Which statements regarding pharmacodynamics and pharmacokinetics of statins are accurate?

Statins reduce cholesterol production through inhibition of hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase. Hepatocytes increase the number of low-density lipoprotein (LDL) receptors in response to decreased cholesterol synthesis by statins to remove cholesterol from circulation.

Which teaching points would a nurse share with a 33-year-old female patient who was prescribed statin therapy?

The patient should avoid pregnancy while receiving therapy with a statin. Gastrointestinal distress can be minimized by taking with food and/or with at least 6 to 8 oz of water. Ensure she is getting plenty of exercise and a diet rich in vegetables, fruits, and fiber to help lower cholesterol levels.