Pharm Ch32: Atorvastatin (Lipitor)

THERAPEUTIC

antihyperlipidemic

PHARMACOLOGIC

statin

TREATS

blocks synthesis of cholesterol in the liver,
decrease LDL, decrease VLDL, decrease cholesterol, idecrease triglycerides

MECHANISM OF ACTION

blocks HMG-CoA reductase in the liver

ROUTE

PO

METABOLISM

hepatic, extensive metabolites

EXCRETION

biliary

ADVERSE EFFECTS

headache
GI - ABD cramping, diarrhea, constipation
life threatening - rhabdomyolyis - renal failure
s/s muscle pain, BLE weakness, fever, fatigue

BLACK BOX

n/a

CONTRAINDICATIONS & PRECAUTIONS

liver dz - increase LFTs (AST/ALT)
pregnancy (birth defects)/lactation

DRUG INTERACTIONS

increase digoxin lvls
decrease metabolism = increase risk for toxicity, increase risk of rhabdomyoIysis
erythromycin - increase Lipitor lvls
St. John's wort - decrease efficacy
grapefruit juice - increase toxicity

OVERDOSE TX

No specific tx

NURSING RESP / PT TEACHING

monitor LFTs (AST/ALT)
take at night when increase biosynthesis of cholesterol
monitor for s/s of rhabdomyolysis
diet, exercise, fish oil, flaxseed
no ETOH, quit smoking
no pregnancy/lactation