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Lately found to also increase glycosylated hemoglobin and fasting blood sugar levels. The half-life
for atorvastatin can be as long as 14 hours, while its metabolites can have a half-life ranging from 20
to 30 hours. Advise the patient on the recommended daily dosage and to avoid taking double doses
to make up for any missed dose. Check medical history for: 70 years of age and aboveHistory of
liver or renal diseaseLarge alcohol consumptionMusculoskeletal disordersDiabetes myopathy or
rhabdomyolysis (or family history of such) atorvastatin may cause myopathy, liver or renal
impairment, and high blood glucose levels, and therefore should be prescribed with caution in
patients included in the listed risk groups. It is available as single and in combination with other
antihypertensive drugs. The drug can cross the placental barrier and has been associated with causing
fetal defects and malformations. Patients complaining of musculoskeletal involvement may need to
have their CPK levels examined. Since the risk for myopathy and rhabdomyolysis is reportedly
higher in renal impairment patients who are using atorvastatin, patients with kidney impairments
should be closely monitored for signs of any musculoskeletal disorders. However, should the patient
be recommended for atorvastatin therapy, the patient should be informed that some cholesterol-
lowering foods, such as certain whole grains, may affect absorption and serum levels of the drug.
Elevated levels of cholesterol and lipids (i.e. hypercholesterolemia) put patients at higher risk for
coronary artery disease (CAD), which can lead to life-threatening health conditions, primarily
myocardial infarction (MI) or heart attack. Oral contraceptives (norethindrone and ethinyl estradiol)
increases hormone values. For pediatric patients with heterozygous familial hypercholesterolemia
(ages 10 to 17 years old): Give initial dose of 10 mg tablet once daily, with adjustment intervals
being at least 4 weeks. Contraindication: atorvastatin should not be prescribed to a pregnant woman
or lactating mother as these drugs can potentially harm the fetus or newborn, as there can be a
disruption in infant lipid metabolism. Atorvastatin levels may be increased when being taken with
certain antiretroviral drugs. Thus, dose adjustment is typically not required for these types of
patients. Teach the importance of adherence to treatment regimen to prevent adverse cardiac events
such as myocardial infarction, angina, revascularization procedures, hospitalizations, and stroke.
Instruct female patients of childbearing age to tell their doctor as soon as they believe or know they
are pregnant. If the patient really requires statin treatment, breastfeeding should be avoided. Collect
bloods for thyroid function tests as indicated. The drug may be put on hold in the event of severe
illness or acute injury. See Full PDF Download PDF See Full PDF Download PDF Related Papers
Journal of Thrombosis and Haemostasis Decrease of hemostatic cardiovascular risk factors by
aggressive vs. The substantial LDL-C reductions and improvements in other lipid measures with
rosuvastatin treatment should facilitate achievement of lipid goals and reduce the requirement for
combination therapy in patients with severe hypercholesterolemia. Rosuvastatin has also been shown
to be highly effective in reducing LDL-C, increasing high-density lipo-protein cholesterol (HDL-C),
and producing favorable modifications of other elements of the atherogenic lipid profile in a wide
range of dyslipidemic patients. To ensure that the atorvastatin did not cause any adverse effects to
the patient’s kidneys or liver. Symptomatic treatment should be given to the patient. The medical
information on this site is provided as an information resource only and is not to be used or relied on
for any diagnostic or treatment purposes. The ratio derivative spectroscopic method involves
measurement of first derivative amplitude of ratio spectra at 240.01nm for FINA and 229.91 nm for
TAM as two wavelengths for estimation. Taking these two drugs together may cause an increase in
atorvastatin levels in the blood and increase the likelihood of adverse reactions to atorvastatin. The
proposed methods for analysis of the four drugs from marketed formulation and plasma have been
validated as per ICH and USFDA guidelines, respectively. Nursing Evaluation Nursing Interventions
for Atorvastatin Rationales Ask the patient to repeat the information about atorvastatin.
Contraindication: atorvastatin should not be prescribed to a pregnant woman or lactating mother as
these drugs can potentially harm the fetus or newborn, as there can be a disruption in infant lipid
metabolism. As a cardiac prophylactic to lower the risk of cardiac events in people who have several
risk factors. Lactating mothers are advised not to take atorvastatin while actively breastfeeding. A
large, long-term clinical trials program is under way to investigate the effects of rosuvastatin on
atherosclerosis and cardiovascular morbidity and mortality. For patients with impaired hepatic
function, such as those with chronic liver disease, increased plasma levels of the drug are known to
occur. Cyclosporine increases bioavailability of atorvastatin. In addition, rosuvastatin's effects in
reducing triglycerides, triglyceride-containing lipoproteins, non-HDL-C, and LDL-C and increasing
HDL-C in patients with mixed dyslipidemia or elevated triglycerides should be of considerable value
in enabling achievement of LDL-C and non-HDL-C goals in the numerous patients with combined
dyslipidemias or metabolic syndrome who require lipid-lowering therapy. Teratogenic drugs can harm
the development of embryo or fetus. Taking some vitamins in high doses while taking atorvastatin
may increase the risk for adverse reactions to the latter. Indications of Atorvastatin Cholesterol is a
fatty substance used by the body to produce hormones and certain vitamins. Patients should limit
drinking grapefruit juice while taking atorvastatin, as grapefruit juice was found to increase the
drug’s serum levels by inhibiting the body from metabolizing atorvastatin properly, and potentially
increasing the risk for liver damage. Alternatives to atorvastatin should therefore be considered in
case of allergy. Atorvastatin has been found to increase toxicity levels of some chemotherapeutic
drugs and may be considered for a different antilipemic if the patient is for chemotherapy. Advise the
patient to take the medication at the same time every day to maximize its effect. If a patient needs to
lower LDL levels by more than 45%, dosage may start at 40 mg tablet once daily. The clinical and
pharmaceutical analysis of this drug requires effective analytical procedures for quality control and
pharmacodynamics and pharmacokinetic studies as well as stability study. This review covers the
most recent many analytical methods including spectrophotometric methods, chromatographic
method including HPLC, HPTLC and RP HPLC, liquid chromatography tendam mass spectroscopy
were reported. It is of note that, as of now, atorvastatin has not yet been studied in, and therefore not
prescribed in the management of Fredrickson dyslipidemia types I and V. The patient should still
adhere to dietary and lifestyle modifications in addition to adhering to the prescribed drug regimen
to achieve the best possible outcome. If taking the drug is necessary, the mother should be advised to
discontinue nursing and use alternative means (like donated breastmilk) to feed their babies. Lately
found to also increase glycosylated hemoglobin and fasting blood sugar levels. To ensure that the
right form of atorvastatin is given through the right route. Atorvastatin can also be widely distributed
in breast milk. Instruct the patient on how to self-administer oral atorvastatin. Use with caution in
patients with a history of heavy alcohol consumption, liver disease if the benefits outweigh the risks.
Rifampin and other cytochrome P450 3A4 inducers decrease plasma atorvastatin levels. Since the
risk for myopathy and rhabdomyolysis is reportedly higher in renal impairment patients who are
using atorvastatin, patients with kidney impairments should be closely monitored for signs of any
musculoskeletal disorders. Among phenol containing systems where we mostly observed
discoloration due to the oxidation of hindered phenol, the combination of secondary HAS, tertiary
HAS, organo-phosphite and hindered phenol exhibited improved stabilization efficiency than single
or binary additive systems. The mixture of secondary HAS and tertiary HAS, has shown antagonistic
effect of stabilization. Because it increases risk of renal failure secondary to rhabdomyolysis.
However, should the patient be recommended for atorvastatin therapy, the patient should be
informed that some cholesterol-lowering foods, such as certain whole grains, may affect absorption
and serum levels of the drug.
To browse Academia.edu and the wider internet faster and more securely, please take a few seconds
to upgrade your browser. For pediatric patients with heterozygous familial hypercholesterolemia
(ages 10 to 17 years old): Give initial dose of 10 mg tablet once daily, with adjustment intervals
being at least 4 weeks. You can download the paper by clicking the button above. Atorvastatin may
cause an increase in serum levels of certain cardiac medications, leading to toxicity and related
adverse reactions. Atorvastatin has been found to increase toxicity levels of some chemotherapeutic
drugs and may be considered for a different antilipemic if the patient is for chemotherapy.
Nevertheless, patients with considerable renal impairment may still need to be observed, especially if
they are taking other drugs with similar mechanisms of action, metabolism, and elimination as
atorvastatin. Valsartan is rapidly absorbed after oral administration. Grapefruit juice can increase
serum statin levels, which may lead to drug toxicity. You can download the paper by clicking the
button above. Increases serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and
Creatine Kinase (CK) levels. Using atorvastatin and certain immunosuppressants together can
increase the risk for adverse reactions to atorvastatin, particularly the risk for myopathy. In addition,
rosuvastatin's effects in reducing triglycerides, triglyceride-containing lipoproteins, non-HDL-C, and
LDL-C and increasing HDL-C in patients with mixed dyslipidemia or elevated triglycerides should
be of considerable value in enabling achievement of LDL-C and non-HDL-C goals in the numerous
patients with combined dyslipidemias or metabolic syndrome who require lipid-lowering therapy. Do
not use atorvastatin in patients who are suspected or confirmed to be pregnant, as use of the drug
has been connected to musculoskeletal malformations in the fetus. Such immunosuppressants should
not be used with the drug. Should myopathy escalate to IMNM, patients should be prescribed
immunosuppressive medications. Previous allergic reaction to atorvastatin or any of its contents may
render the patient unable to take them. Buy on Amazon Disclaimer: Please follow your facilities
guidelines, policies, and procedures. Deficient knowledge related to drug’s adverse effects; disease
process. Even though the prevalence of hypercholesterolaemia in type 2 diabetes is similar to that of
the general population, elevated triglyceride and reduced HDL-chol levels are found much more
frequently in association with diabetes. Strong CYP3A4 inhibitors (such as clarithromycin,
erythromycin, protease inhibitors, itraconazole) can increase plasma atorvastatin levels. Thus, dose
adjustment is typically not required for these types of patients. The enzyme that it needs to target is
more active at night. Advise patients to be cautious when taking over the counter or herbal drugs, as
atorvastatin has been known to have adverse drug interactions with different types of medications. If
a patient needs to lower LDL levels by more than 45%, dosage may start at 40 mg tablet once daily.
The patient may either take atorvastatin and the antibiotic or antifungal together but under closer
monitoring, or be prescribed a different type of antilipemic. If antilipemic drug therapy is still
necessary for the patient, the current atorvastatin dose can either be resumed but in a reduced dosage
or replaced by a different type of antilipemic drug. Atorvastatin is contraindicated in the following
patients: hypersensitivity to atorvastatin or similar drugs, patients with active liver disease (e.g.
hepatitis) or history of alcoholic liver disease, and patients with persistently elevated transaminase
levels. Categories Nursing Diagnosis Care Plans, Pharmacology For Nurses Leave a Comment
Cancel reply Comment Name Email Website. Patients should also have baseline data for
musculoskeletal and neurological assessment since most of the atorvastatin’s most alarming adverse
reactions (myopathy and rhabdomyolysis) involve these systems. Patients taking atorvastatin should
have their lipid levels monitored within 2 to 4 weeks of continuous therapy, and their hepatic
function tests, within 6 to 12 weeks after starting atorvastatin therapy. It is available as single and in
combination with other antihypertensive drugs.
RN, BSN, PHN Last updated on May 16th, 2022 at 03:48 pm Atorvastatin Nursing Implications
Atorvastatin Nurse Teaching Atorvastatin is a type of antilipemic or antihyperlipidemic agent, a
medication that lowers cholesterol and lipid serum levels. Treating this condition may correct the
problem without the need for taking atorvastatin. Check medical history for: 70 years of age and
aboveHistory of liver or renal diseaseLarge alcohol consumptionMusculoskeletal disordersDiabetes
myopathy or rhabdomyolysis (or family history of such) atorvastatin may cause myopathy, liver or
renal impairment, and high blood glucose levels, and therefore should be prescribed with caution in
patients included in the listed risk groups. Buy on Amazon Silvestri, L. A. (2020). Saunders
comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Angiotensin II
receptor type I antagonists have been widely used in the treatment of hypertension, heart failure,
myocardial infraction and diabetic nephropathy. Hepatic function should then be monitored
periodically thereafter if drug therapy will be continued. Deficient knowledge related to drug’s
adverse effects; disease process. They must be used with caution in people with impaired renal
function. See Full PDF Download PDF See Full PDF Download PDF Related Papers Journal of
Thrombosis and Haemostasis Decrease of hemostatic cardiovascular risk factors by aggressive vs.
Excretion of atorvastatin and its metabolites is done through the liver and eliminated through the
bile, which is then excreted in the urine and feces. Grapefruit juice can increase serum statin levels,
which may lead to drug toxicity. Conversely, this causes HDL levels to slightly increase due to this
metabolic change. HMG-CoA reductase is an enzyme that converts HMG-CoA into mevalonate
acid, a conversion process that is an important step in the biosynthesis of cholesterol. These plaques
can eventually break off and block arteries, putting patients at risk for other, potentially more fatal
conditions like myocardial infarction and stroke. Hypoactive thyroid can cause high cholesterol
levels. Instruct the patient on how to self-administer oral atorvastatin. Since most of the metabolism
and elimination is done by the liver, renal function is not as important in determining patient
compatibility with the drug compared to hepatic function. Educate the patient about the action,
indication, common side effects, and adverse reactions to note when taking atorvastatin. However,
we aim to publish precise and current information. To check if the atorvastatin is effective, the dose
needs to be adjusted, or the drug should be stopped and changed to an alternative treatment. These
contents are not intended to be used as a substitute for professional medical advice or practice
guidelines. Atorvastatin should not be prescribed to a pregnant woman as these drugs can potentially
harm the fetus or newborn, as there can be a disruption in infant lipid metabolism Collect blood for
liver function tests (LFTs). The patient should still adhere to dietary and lifestyle modifications in
addition to adhering to the prescribed drug regimen to achieve the best possible outcome. This
review covers the most recent many analytical methods including spectrophotometric methods,
chromatographic method including HPLC, HPTLC and RP HPLC, liquid chromatography tendam
mass spectroscopy were reported. However, the combination of organo-phosphite with secondary
HAS, tertiary HAS and phenol antioxidants have been found to give synergistic even at higher doses
of gsterilization. The effect of the organo-phosphite antioxidant on the overall stability has been
discussed. Observe for symptoms of GI irritability and hepatic dysfunction (e.g.; jaundice). Observe
for musculoskeletal symptoms such unexplained muscle pain, tenderness, or weakness. To browse
Academia.edu and the wider internet faster and more securely, please take a few seconds to upgrade
your browser. To ensure optimal absorption and therapeutic action by atorvastatin. Atorvastatin is
primarily prescribed for its cholesterol-lowering effects to reduce the risk for coronary artery disease
in patients with abnormal lipid profile (elevated LDL, total cholesterol) results, with or without
additional risk factors, in combination with dietary and other lifestyle modifications.
The drug should also be avoided by women of childbearing age, especially those who are planning to
have children. Food decreases the exposure of Valsartan by about 40% and peak plasma
concentration by about 50%. 94%-97% of drug bound to serum protein mainly albumin. Do not use
atorvastatin in patients who are suspected or confirmed to be pregnant, as use of the drug has been
connected to musculoskeletal malformations in the fetus. Medication should not be crushed, chewed,
or cut prior to intake. Patients complaining of musculoskeletal involvement may need to have their
CPK levels examined. The proposed methods for analysis of the four drugs from marketed
formulation and plasma have been validated as per ICH and USFDA guidelines, respectively.
Certain antacids are made up of chemicals that decrease the drug level of atorvastatin and similar
drugs when taken together. They must be used with caution in people with impaired renal function.
Rosuvastatin has also been shown to be highly effective in reducing LDL-C, increasing high-density
lipo-protein cholesterol (HDL-C), and producing favorable modifications of other elements of the
atherogenic lipid profile in a wide range of dyslipidemic patients. The ratio derivative spectroscopic
method involves measurement of first derivative amplitude of ratio spectra at 240.01nm for FINA
and 229.91 nm for TAM as two wavelengths for estimation. To ensure that the atorvastatin did not
cause any adverse effects to the patient’s kidneys or liver. Female pediatric patients should be at
least one year post menarche before being prescribed this medication. Assess the patient for signs
and symptoms of hypercholesterolemia. You can download the paper by clicking the button above.
Studies found that taking the drugs together can increase the patient’s risk for critical adverse
reactions such as myopathy, peripheral neuropathy, and rhabdomyolysis. To browse Academia.edu
and the wider internet faster and more securely, please take a few seconds to upgrade your browser.
The patient should still adhere to dietary and lifestyle modifications in addition to adhering to the
prescribed drug regimen to achieve the best possible outcome. Because atorvastatin needs to be
discontinued as it is contraindicated during pregnancy. Ensure atorvastatin is not given to the
patients on cyclosporine, gemfibrozil, tipranavir plus ritonavir, or telaprevir. RELATED TOPICS
Elsevier See Full PDF Download PDF About Press Blog People Papers Topics Job Board We're
Hiring. To confirm the indication for administering atorvastatin. Lately found to also increase
glycosylated hemoglobin and fasting blood sugar levels. Atorvastatin levels may be increased when
being taken with certain antiretroviral drugs. Check medical history for: 70 years of age and
aboveHistory of liver or renal diseaseLarge alcohol consumptionMusculoskeletal disordersDiabetes
myopathy or rhabdomyolysis (or family history of such) atorvastatin may cause myopathy, liver or
renal impairment, and high blood glucose levels, and therefore should be prescribed with caution in
patients included in the listed risk groups. This can be avoided by spacing the intake of these drugs
apart. Instruct female patients of childbearing age to tell their doctor as soon as they believe or know
they are pregnant. Taking atorvastatin while undergoing treatment using certain types of antibiotics
or antifungals may lead to increased drug levels and amplified side effects of the former. Others: flu-
like symptoms (i.e. cough, runny nose) Adverse Reactions to Atorvastatin One of the noteworthy
adverse reactions to atorvastatin is the risk of developing rhabdomyolysis and acute renal failure,
especially for patients with impaired kidney function. The drug may be put on hold in the event of
severe illness or acute injury. Treating this condition may correct the problem without the need for
taking atorvastatin.