Medicine & USMLE

Statins (Old)

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Statins are a class of lipid-lowering drugs that are easily recognizable because they all end in -statin, like atorvastatin, pravastatin, lovastatin and simvastatin. The statin drugs are also called HMG-CoA reductase inhibitors, because they work to block the enzyme, HMG-CoA Reductase, which is an important enzyme involved in the synthesis of cholesterol. Clinically, statins are used to lower cholesterol levels, treating hypercholesterolemia and coronary artery disease. It’s important to teach the patient to take statin drugs in the evening to achieve their full effect. Side effects to know about the statins include myopathy and hepatotoxicity.

Key Points

  • Drug Names
    • Lovastatin, Simvastatin, Rosuvastatin, Atorvastatin, Pravastatin
    • Mechanism
      • Antihyperlipidemic
        • Inhibits HMG-CoA reductase, an early component in cholesterol biosynthesis
        • Most of the cholesterol in the body is synthesized during the fasting state at night.
          • Should be taken in the evening
    • Clinical use
      • Hypercholesterolemia
        • Reduces LDL, VLDL cholesterol
        • Raises HDL cholesterol
      • Coronary Artery Disease
        • Risk reduction for myocardial infarction, stroke, atherosclerosis
    • Side Effects and Adverse Reactions
      • Myopathy
        • Generalized muscle pain/weakness
        • Can turn into rhabdomyolysis
        • Monitor CK levels while on treatment
      • Hepatotoxicity
        • Monitor liver enzymes
      • May be Teratogenic
        • Pregnancy Risk Category X
      • Abrupt discontinuation can cause rebound hypercholesterolemia and myocardial infarction