12 Questions
Which statin can decrease LDL by more than 50%?
Atorvastatin
What is the side effect of statins associated with muscle pain?
Rhabdomyolysis
Which medication is an inhibitor of microsomal triglyceride transfer protein and is only used for familial hypercholesterolemia?
LoMiTaPide
What is the recommended treatment if a patient experiences myalgia with lipophilic statins like Atorvastatin or Simvastatin?
Switch to Rosuvastatin or Pravastatin
Which medication lowers LDL by 60% and can be used as monotherapy or in combination with a statin for all cases of hypercholesterolemia?
Evolocumab
What should be monitored after initiating treatment with Evolocumab?
Lipid profile at baseline, then 4-12 weeks, and then 3-12 months
Which medication can be used in conjunction with high-dose statin to reduce LDL in patients with LDL > 190, but is only prescribed by certified specialists due to the risk of hepatotoxicity?
LoMiTaPide
Which medication increases A1C and blood glucose as an adverse drug reaction, and is lipophilic with a longer half-life leading to higher risk of myalgia?
Atorvastatin
In the context of statin therapy, what should be replaced through supplementation in patients taking LoMiTaPide due to its mechanism of action?
Essential fatty acids
Which medication is a PCSK9 inhibitor and can be used as monotherapy or in combination with a statin for all cases of hypercholesterolemia, and comes with a risk of hypersensitivity/angioedema?
Evolocumab
If a patient experiences myalgia with lipophilic statins like Atorvastatin or Simvastatin, what is the recommended alternative statin therapy?
Rosuvastatin
What is the maximum effect of Atorvastatin typically seen after initiating treatment?
@ 2-4 weeks
Study Notes
Statin Therapy
- Rosuvastatin can decrease LDL by more than 50%.
Statin-Associated Side Effects
- Myalgia (muscle pain) is a side effect of statins associated with muscle pain.
Medications for Hypercholesterolemia
- Lomitapide is an inhibitor of microsomal triglyceride transfer protein, only used for familial hypercholesterolemia.
- Evolocumab lowers LDL by 60% and can be used as monotherapy or in combination with a statin for all cases of hypercholesterolemia.
Treatment Alternatives
- If a patient experiences myalgia with lipophilic statins like Atorvastatin or Simvastatin, the recommended alternative statin therapy is Pravastatin or Fluvastatin.
- In cases of myalgia, switching to a hydrophilic statin like Pravastatin or Fluvastatin is recommended.
Monitoring and Supplementation
- After initiating treatment with Evolocumab, LDL levels should be monitored.
- When taking Lomitapide, vitamin E supplementation is necessary due to its mechanism of action.
Medication Interactions and Contraindications
- Mipomersen is only prescribed by certified specialists due to the risk of hepatotoxicity, and can be used in conjunction with high-dose statin to reduce LDL in patients with LDL > 190.
- Pitavastatin increases A1C and blood glucose as an adverse drug reaction, and is lipophilic with a longer half-life leading to a higher risk of myalgia.
- Alirocumab is a PCSK9 inhibitor that can be used as monotherapy or in combination with a statin for all cases of hypercholesterolemia, and comes with a risk of hypersensitivity/angioedema.
Statin Pharmacokinetics
- The maximum effect of Atorvastatin is typically seen after 4-6 weeks of initiating treatment.
Test your knowledge about Atorvastatin and other statin medications, including their effects on LDL cholesterol, side effects, and monitoring requirements. Learn about the management of myalgia and high LDL levels with different statins.
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