Drug Study

Atorvastatin(lipitor) fourty mg one tablet once a day at HS eight pm

DRUG CLASS AND MECHANISM: Atorvastatin is an oral drug that lowers the level of cholesterol in the blood. It belongs to a class of drugs referred to as statins, which includes lovastatin (Mevacor), simvastatin, (Zocor), fluvastatin (Lescol), and pravastatin (Pravachol) and rosuvastatin (Crestor). All statins, including atorvastatin, prevent the production of cholesterol in the liver by blocking HMG-CoA reductase, an enzyme that makes cholesterol. Statins reduce total cholesterol as well as LDL cholesterol in blood. LDL cholesterol is believed to be the "bad" cholesterol that is primarily responsible for the development of coronary artery disease. Reducing LDL cholesterol levels retards progression and may even reverse coronary artery disease. Atorvastatin also raises the concentrations of HDL ("good") cholesterol that protects against coronary artery disease and reduces the concentration of triglycerides in the blood.

Indications
Reduce risk of stroke & heart attack in type 2 diabetes patients without evidence of heart disease but with other risk CV factors
Reduce risk of stroke, heart attack and revascularizations procedures in patients without evidence of coronary heart disease (CHD) but with multiple risk factors other than diabetes (eg, smoking, HTN, low HDL-C, family history of early CHD)
Patients with CHD to reduce risks of MI, stroke, revascularization procedures, hospitalization for CHF, and angina

CONTRAINDICATIONS
Active liver disease, which may include unexplained persistent elevations in hepatic transaminase levels

Hypersensitivity to any component of this medication

Pregnancy

Women who are pregnant or may become pregnant. LIPITOR may cause fetal harm when administered to a pregnant woman. Serum cholesterol and triglycerides increase during normal pregnancy, and cholesterol or cholesterol derivatives are essential for fetal development. Atherosclerosis is a chronic process and discontinuation of lipid-lowering drugs during pregnancy should have little impact on the outcome of long-term therapy of primary hypercholesterolemia. There are no adequate and well-controlled studies of LIPITOR use during pregnancy; however in rare reports, congenital anomalies were observed following intrauterine exposure to statins. In rat and rabbit animal reproduction studies, atorvastatin revealed no evidence of teratogenicity. LIPITOR SHOULD BE ADMINISTERED TO WOMEN OF CHILDBEARING AGE ONLY WHEN SUCH PATIENTS ARE HIGHLY UNLIKELY TO CONCEIVE AND HAVE BEEN INFORMED OF THE POTENTIAL HAZARDS. If the patient becomes pregnant while taking this drug, LIPITOR should be discontinued immediately and the patient apprised of the potential hazard to the fetus

Generic Name
Brand Name
Dosage
Frequency
Indications
Contraindications
Nx Consideration
Atorvastatin
Lipitor

· To reduce the risk of MI, stroke, angina, and revascularization procedures in patients with no evidence of CAD with multiple risk factors.
· Heterozygous familial hypercholesterolemia.
· Adjunct to diet to reduce elevated LDL, total cholesterol, apo B, and triglyceride levels to increase HDL level in patients with primary hypercholesterolemia and mixed dyslipidemia.
· Contraindicated in patients hypertensive to the drug and in those with active liver disease or conditions linked with unexplained persistent increases in transaminase levels.
· Adolescent girl must be at least 1 year post-menarche
· Monitor patient’s lipid and liver function levels at baseline and periodically thereafter.
· Monitor patient for signs of rhabdomyolyis, especially if taking more than one class of lipid lowering drugs.
· Asses patient’s and family’s knowledge of drug therapy.