Hypercholesterolaemia

Question 1

Hyperlipidaemia : Statin MOA

Answer 1

1. Statins inhibit the action of HMG-CoA reductase
2. the rate-limiting enzyme in hepatic cholesterol synthesis.

Question 2

Statin : Adverse effects

Answer 2

1. Myopathy :
   * Mylagia : general muscle pain
   * Rhabdomyolysis
   > higher risk in T2DM

2 . Liver impairment
* LFTs checked at 3 months and 12 months
* Stop if >3x baseline

Question 3

Statin : Contraindication

Answer 3

1. Macrolides : Erythromycin, Clarithromycin
2. Pregnancy

Question 4

Primary prevention : Indication for statin

Answer 4

Atorvastatin 20mg OD - increase dose if non HDL not reduced > 40%

1. QRISK >10%
2. Type 1 diabetes > 10 years after diagnosis
3. CKD egFR <60

Question 5

Secondary prevention : Indication for statin

Answer 5

Atorvastatin 80mg OD
1. Known IHD
2. Stroke
3. Peripheral arterial disease