Now we talk about Hydroxymethyl-glutaryl-CoA Reductase Inhibitors. They are easy to recognize as they end in -statin and these are quite possibly the most prescribed drugs today.
- Lovastatin (Mevacor)
- Pravastatin (Pravachol)
- Simvastatin (Zocor)
- Atorvastatin (Lipitor)
- Fluvastatin (Lescol)
This drug reduces the conversion of HMG-CoA to mevalonic acid, which is the precursor to cholesterol. So this decreases the body’s production of cholesterol, so therefore it inhibits LDL production. This drug is extremely powerful. We could take patients from the 300-400’s to the low 100’s. Extremely powerful. Studies come out all the time showing that these drugs are associated with a reduced chance of cancer and some cardiovascular diseases.
What could go wrong with a drug like this? We have to monitor these patients.
There’s less chance of cardiovascular disease and GI cancer but we must monitor peoples Liver Function Tests (LFT’s). If we see damage to the liver occurring we have to stop. So the LFT’s must be monitored. We also found that people’s vision goes down with this drug. The other major complaint are muscle cramps. Muscle cramps are a huge warning of rhabdomyolysis which well look at later.
Recap
- Reduces conversion of HMG-CoA to mevalonic acid (precursor to cholesterol)
- Inhibits LDL production
- Dramatic reduction of LDL’s
- Monitor LFT’s and retina
