NAME OF DRUG Generic name: Simvastatin Brand name:

DOSE, ROUTE AND FREQUENCY Dose: 40 mg Route: PO Frequency: OD HS

MECHANISM OF ACTION Inhibits an enzyme, 3hydroxy-3methylglutarylcoenzyme (HMG-CoA) reductase, which is responsible for catalysing an early step in the synthesis of cholesterol. Therapeutic Effects: >Lowering of total and LDL cholesterol. >Increase HDL and decrease VLDL cholesterol and triglycerides. >Slowing of the progression of coronary artery disease with resultant decrease in MI/stroke and need for myocardial revascularization.

INDICATIONS

CONTRAINDICATIONS

ADVERSE EFFECT
CNS: Dizziness, headache, insomnia, weakness EENT: rhinitis RESPI: bronchitis GI: abdominal cramps, constipation, diarrhea, flatus, heartburn, altered taste, drug-induced hepatits, dyspepsia, elevated liver enzymes, nausea, pancreatitis GU: impotence DERM: rashes, pruritus MS: rhabdomyolysis, arthralgia, arthritis, myalgia, myositis MISC: hypersensitivity reactions

NURSING CONSIDERATION -Obtain a dietary history, especially with regard to fat consumption. -Evaluate serum cholesterol and triglyceride levels before initiating, after 4-6 weeks therapy, and periodically thereafter. -Monitor liver function tests. -Administer once daily in the evening. May be administered without regard to food. -Instruct patient to take medication as directed and not to skip doses or double up on missed doses.

Classification: Lipid-lowering agent

Adjunct to dietary therapy in the management of primary hypercholesterolemia and mixed dyslipidemias.

Reduction of lipids/cholesterol reduces the risk of MI and stroke sequelae and decreases the need for Use cautiously in: bypass History of liver disease or procedures/angioplasty. significant alcohol use/abuse.

Contraindicated in: hypersensitivity, crosssensitivity among agents may occur. Sepsis, acute hypotension, major surgery, trauma, severe metabolic disturbances, endocrine or electrolyte disorders, uncontrolled seizures and active liver disease.

Instruct patient to notify health care professional if unexplained muscle pain, tenderness or weakness occurs, especially if accompanied by fever or malaise. Emphasize the importance of follow-up exams to determine effectiveness and to monitor for side effects.