Statins

Question 1

What are examples of statins?

Answer 1

• Simvastatin
• Atorvastatin
• Prevastatin
• Rosuvastatin

Question 2

What are common indications for statin use?

Answer 2

• Primary prevention of CVS disease
• Secondary prevention of CVS disease
• Primary hyperlipidaemia

Question 3

What is first line treatment for primary hyperlipidaemia?

Answer 3

Statins

Question 4

What is the mechanism of action of statins?

Answer 4

HMG-CoA reductase inhibitor - Decrease cholesterol production by the liver and increase clearance of LDL-cholesterol from the blood, reducing LDL-levels. They also indirectly reduce triglycerides and slightly increase HDL levels

Question 5

What are important adverse side effects of statin use?

Answer 5

• Headache
• GI disturbance
• Muscle ache/myopathy
• Rhabdomyolysis
• Raised liver enzymes/drug-induced hepatitis

Question 6

When should caution be used when using statins?

Answer 6

• Hepatic impairment
• Renal impairment - renally excreted
• Pregnancy/breastfeeding

Question 7

What are important interactions to be aware of with statin use?

Answer 7

Cytochrome P450 inhibitors

• Amiodarone
• Diltiazem
• Intraconazole
• Macrolides
• Amlodipine

Question 8

When are statins traditionally prescribed?

Answer 8

In the evening

Question 9

What is the traditional starting dose of simvastation?

Answer 9

40mg daily

Question 10

What is the traditional starting dose of atorvastatin?

Answer 10

10mg daily

Question 11

What monitoring would you consider doing for someone on a statin?

Answer 11

• Lipid profile before treatment
• LFTs at 3 months and 12 months

Question 12

What would you advise those taking statins to avoid?

Answer 12

GRapefruit juice

Question 13

What symptoms would you be particularly interested in patients reporting if they were on statins?

Answer 13

Muscle symptoms

Question 14

What is important to check for in females who you are about to start on statins?

Answer 14

Pregnancy

Question 15

What bloods would you check before starting someone on statins?

Answer 15

LFTs - check again at 3 and 12 months