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Precautions of using a statin?
- severe intercurrent illness - increases risk of myopathy
- rhabdomyolysis and renal failure
Which statins are hepatically removed?
Adverse Effects of statins?
myalgia, GI symptoms, insomnia,
myopathy, rhabdomyolysis, hepatitis,
Which statins have the most interactions?
atorvastatin and simvastatin
Monitoring of statins?
aminotransferase and CK at baseline
Dose of atorvastyatin?
Dose of pravastatin?
40mg daily if unstable angina and post MI
Dose of simvastatin?
What effect do fibrates have on the lipid profile?
decrease TG and increase HDL
Indications for fenofibrate?
- severe hypertriglyceridaemia
- dyslipidaemia associated with type two diabetes
Contraindicatiosn for fenofibrate?
severe renal impairment
Adverse effects of fenofibrate?
Increased aminotransferase concentrations, gi disturbances, dyspepsia, photosensitivity, myopathy
pancreatitis, VTE, rash
Dose of fenofibrate?
- 145mg daily
- reduce in renal impairment
Counselling of fenofibrate?
See doc if you have brown urine, or any muscle pain, tenderness or weakness.
Avoid sun exposure, wear hat and sunscreen
Will need blood tests every 3 months for the first year
Indications of ezetimibe?
- In combination with a statin, if a statin isnt effective
Precautions of ezetimibe?
Treatment with fenofibrate - may increase risk of gall bladder disease
Adverse effects of ezetimibe?
headache, diarrhoea, myalgia, raised ALT
Dose of ezetimibe?
Counselling for ezetimibe?
Tell your doctor if you have any muscle pain, tenderness or weakness.