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Drugs Dictionary: Atorvastatin

Atorvastatin

Trade Name

Lipitor (primary brand name); generic atorvastatin

Classification

HMG-CoA reductase inhibitor (statin); lipid-lowering agent

Dosage/Route

  • * Dosage: Tablets: 10 mg, 20 mg, 40 mg, 80 mg
  • * Route: Oral (PO)

Usual Dosage

10-20 mg once daily (initial); may increase to 80 mg daily max, based on cholesterol goals and patient response

Mechanism of Action

Inhibits HMG-CoA reductase in the liver, reducing LDL cholesterol synthesis, upregulating LDL receptor activity, and modestly increasing HDL cholesterol. Lowers triglycerides as a secondary effect

Side Effects & Adverse Effects

  • * Side Effects: Muscle pain (myalgia), headache, nausea, diarrhea.
  • * Adverse Effects:
    •      – Rhabdomyolysis (rare; severe muscle breakdown, dark urine, elevated CK).
    •      – Hepatotoxicity (elevated liver enzymes, jaundice).
    •      – Diabetes risk (new-onset in susceptible patients)

Nursing Management (Implications & Teachings)

  • * Implications:
    •      – Monitor liver function tests (LFTs) baseline and periodically.
    •      – Assess muscle symptoms and creatine kinase (CK) if pain/weakness occurs.
    •      – Check for interactions (e.g., avoid grapefruit juice—strong CYP3A4 inhibitor).
  • * Teachings:
    •      – Take at bedtime (cholesterol peaks at night).
    •      – Report muscle pain, dark urine, or yellowing skin.
    •      – Follow low-fat diet; avoid excessive alcohol.
    •      – Don’t stop abruptly—consult provider

Indication for This Patient

  • * Hypercholesterolemia (high LDL or triglycerides)
  • * Cardiovascular risk reduction (primary prevention in high-risk patients; secondary prevention post-MI/stroke)

Time

  • * Timing: Once daily, typically at night
  • * Onset: LDL reduction in 1-2 weeks; peak effect in 4-6 weeks
  • * Duration: Continuous with daily dosing

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