Advise patients to avoid breast feeding during therapy.It is currently not known if atorvastatin is safe to use while breast feeding. Some of the brand names for atorvastatin include Lipitor (made by Pfizer), and Atorlip (made by Cadila Pharmaceuticals). Signs and symptoms patients should take note of and report to the prescribing physician right away include the following: sudden, unexplained muscle pain or weakness, fever, swelling, unusual bleeding, dark-colored urine, or yellowing of skin and eyes indicative of jaundice. Administration Oral May be given at any time of day. Nursing care plans: Diagnoses, interventions, & outcomes. Instruct the patient to notify the healthcare professional if there are signs of liver injury, unexplained muscle pain, tenderness, or weakness, especially if accompanied by fever or malaise.In rare cases, atorvastatin may cause liver damage. It is also important to maintain a healthy weight and manage any other risk factors for heart disease, such as high blood pressure and diabetes. Pharmacology and the Nursing ProcessThe 10th edition of Pharmacology and the Nursing Process offers practical, user-friendly pharmacology information. Following herbs/foods can decrease the effect of atorvastatin (Lipitor). Instruct the patient that atorvastatin can be taken with or without food. Chronic Kidney Disease (CKD/CRF) Nursing Diagnosis & Care Plan, Albuterol Nursing Considerations & Patient Teachings, Decreasing bad cholesterol (low-density lipoproteins), Increasing good cholesterol (high-density lipoproteins), Reducing cholesterol production in the liver, Inhibiting HMG-CoA reductase (an enzyme needed in cholesterol formation), Type 2 diabetes (with or without evidence of heart disease), Do not use if sensitive to other antihyperlipidemic agents, Do not use with hepatic disease or unexplained elevated serum liver enzymes, Avoid using other HMGCoA reductase inhibitors, Carefully use atorvastatin with cyclosporine, protease inhibitors, colchicine, niacin, clarithromycin, or grapefruit juice, Take caution in women of childbearing age and children younger than age 18, Atorvastatin with antacids, colestipol, efavirenz, and rifampin can decrease atorvastatin blood level, Higher risk of muscle disease (myopathy or, Digoxin can increase digoxin blood levels and cause toxicity, Elevated hormone levels when taken with contraceptives, Poor coordination, numbness, nerve damage, weakness, Orthostatic hypotension, palpitations, arrhythmias, Loss of taste, mouth sores, dry mouth, gingival bleeding, dysphagia, Blood in the stool (melena), intestinal gas (flatulence), Decreased libido and erectile dysfunction, Hair loss, acne, dry skin, pruritus, rash, photosensitivity, excessive sweating (diaphoresis), Assess for allergies to HMG-CoA reductase inhibitors, Obtain baseline cholesterol, triglycerides, and liver function tests, Monitor liver function and creatine kinase level, Assess for signs of muscle weakness or pain, Assess for changes in concentration, alertness, and vision, Do not crush, dissolve, or divide atorvastatin, Determine the goal of therapy in starting atorvastatin, Evaluate the patients response to atorvastatin, For muscle pain, administer pain medications as ordered, Immediately report EKG changes, yellowish discoloration to the skin, muscle weakness, or. Perform a pregnancy test for the female patient. adverse effects. Atorvastatin and vitamins. Jones & Bartlett Learning, LLC. The patient should be advised to get the following laboratories and diagnostics in order to have established baseline data. peak. Increases serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and Creatine Kinase (CK) levels. Inform physician regarding concurrent use of any of the following drugs: erythromycin, niacin, antifungals, or birth control The patient have to talk with a doctor if such clinical problems exist as diabetes, heart disease, heart illness, liver illness or renal system illness. (2021). There are some herbal medications that can decrease the effectiveness of atorvastatin and other similar antilipemic drugs. 6. Atorvastatin is contraindicated in people who have had previous hypersensitivity reactions to the drug. This medicine is available only with your doctor's prescription. 9. Disclaimer: These citations have been automatically generated based on the information we have and it may not be 100% accurate. So its important to inform a healthcare provider if the patient is pregnant or planning to be pregnant, before taking this medication. Because of the increased risk of rhabdomyolysis with acute renal failure. 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. 3) Reducing of LDL cholesterol (18-55% decrease LDL) Increasing HDL cholesterol (5-15& increase) Reducing triglycerides (7-30% decrease) What does Atorvastatin do? Assess for any additional considerations that may be relevant in older adults, such as comorbidities, cognitive impairment, and functional status.Older adults may be at an increased risk for certain side effects when taking atorvastatin or other medications in the statin class. For patients with impaired hepatic function, such as those with chronic liver disease, increased plasma levels of the drug are known to occur. Advise the patient on the possible side effects and adverse reactions to the drug, and to take note of the important signs and symptoms of adverse reactions to watch out for, as drug therapy should be stopped in some cases of adverse reaction. . Monitor chest pain or symptoms of bronchitis (cough, production of sputum, shortness of breath, wheezing). 10 mg/day initially, may be increased every 4 wk up to 20 mg/day; 10 20 mg once daily initially; (may start with 40 mg/day if LDL-C needs to be decreased by >45%); may be increased every 2 4 wk up to 80 mg/day; Concurrent nelfinavir therapy Dose should not exceed 40 mg/ day; Progressive muscle weakness, especially in the proximal muscles (shoulder and hip girdles), Elevated muscle enzymes (creatine kinase). 7. Increase dosage as needed, up to a maximum dose of 80 mg daily as single dose. Read theprivacy policyandterms and conditions. We may earn a small commission from your purchase which will help support us. Nurses Drug Handbook (20th ed.). Anatomy and Physiology ; Care Planning and Nursing Diagnoses ; Communication ; Community and Public Health ; Culture ; Davis Notes for Nurses ; Distance Learning Hub In combination with sexual stimulation, vardenafil works by increasing blood flow to the . 1. Advertisementsif(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'nurseship_com-large-mobile-banner-1','ezslot_4',662,'0','0'])};__ez_fad_position('div-gpt-ad-nurseship_com-large-mobile-banner-1-0');Reduces cholesterol synthesis by inhibiting the HMG-CoA reductase enzyme. Use extreme caution. Evaluate the effectiveness of the atorvastatin (Lipitor): decrease in total cholesterol levels, triglyceride levels, LDL levels, and increase in HDL levels; adherence to pharmacological and non-pharmacological treatment regime. Please read our disclaimer. It is usually prescribed in combination with a healthy diet and lifestyle changes, such as exercise and weight loss. Pharmacology Made Incredibly Easy (Incredibly Easy! Hypersensitivity to other HMG-CoA reductase inhibitors, history of liver disease, patients who consume substantial quantities Thus, dose adjustment is typically not required for these types of patients. Lipitor increases the number of hepatic low-density-lipid (LDL) receptors, thus increasing LDL Advise women with reproductive potential to use effective contraception during therapy and discuss plans to discontinue statins if trying to conceive.Also, advise patient to talk to healthcare professional if she plans to get pregnant. Davis's Drug Guide for Rehabilitation Professionals, https://fadavispt.mhmedical.com/content.aspx?bookid=1873§ionid=139002293. However, we aim to publish precise and current information. Hyperlipidemia. Slightly increases HDL cholesterol. Atorvastatin and bile acid sequestrants. Primary prevention of coronary heart disease (myocardial infarction, stroke, angina, and coronary revascularization) in asymptomatic patients with increased total and low-density lipoprotein (LDL) cholesterol and decreased high-density lipoprotein (HDL) cholesterol. I: Prevention of coronary disease. 13. Kaylee Neff Aileen Lin, MScBMC Antihyperlipidemics are medications used to treat clients with increased blood levels of lipids, like cholesterol, by decreasing the levels of low- density lipoproteins or LDLs, which is sometimes referred to as "bad" cholesterol; and to an extent, antihyperlipidemics can also decrease blood triglycerides. Hypoactive thyroid can cause high cholesterol levels. 2. The pharmacokinetics of atorvastatin refers to the way that the drug is absorbed, distributed, metabolized, and eliminated by the body. These patients are only started on drug therapy if diet and lifestyle modifications are still ineffective in lowering cholesterol levels. Assess the patients pregnancy status and breastfeeding status, and provide appropriate education and resources.Its important to note that there are no adequate and well-controlled studies of atorvastatin in pregnant women and animal studies have shown adverse effects. MOSBYS 2021 NURSING DRUG REFERENCE (34th ed.). Grapefruit juice is not contraindicated for statin-using patients. For prevention of cardiovascular disease: 10 mg/day. This may include providing patient education, monitoring for side effects and potential complications, and implementing interventions to manage any identified risks or problems. The increased risk of rhabdomyolysis associated with increased statin dose is negligible (Lee et al., 2016). Pregnancy. Lately found to also increase glycosylated hemoglobin and fasting blood sugar levels. 5. Because atorvastatin needs to be discontinued as it is contraindicated during pregnancy. To ensure that the atorvastatin did not cause any adverse effects to the patients kidneys or liver. It is important for nurses to carefully assess the patients condition and individual needs, and to develop a plan of care based on the findings. Inform the patient that atorvastatin may be taken at any time of the day.Sometimes healthcare providers may recommend taking it in the evening. Description Histamine-2 antagonists block the release of hydrochloric acid in response to gastrin. Atorvastatin is contraindicated in the following patients: hypersensitivity to atorvastatin or similar drugs, patients with active liver disease (e.g. 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. adverse effects. Antihyperlipidemic: Generic and Brand Names Disease Spotlight: Coronary Artery Disease (CAD) Bile Acid Sequestrants Therapeutic Action Indications Pharmacokinetics Use cautiously in patients with impaired endocrine function due to the drug regimen possibly altering steroid hormone formation. Inhibition of prostaglandin biosynthesis as the mechanism of action of aspirin-like drugs. Symptoms of ED include. Atorvastatin is rapidly absorbed in the bloodstream after oral intake and undergoes extensive first-pass effect in the liver. Certain antacids are made up of chemicals that decrease the drug level of atorvastatin and similar drugs when taken together. Caution not to take double dose. To confirm the indication for administering atorvastatin. Class. Mechanism of action: Atorvastatin reduces the risk of heart disease, stroke, and myocardial infarction (MI) by: Indications for use: Atorvastatin is for patients with the following risks: Off-label uses include secondary prevention in transient ischemic attack (TIA or mini-stroke), or acute coronary syndrome (ACS). Nursing Implications: Check blood pressure and pulse before each administration of NTG-blood pressure can drop precipitously after a single dose. Total cholesterol level: less than 200 mg/dL (5.17 mmol/L). Uses. Atorvastatin is also used in the treatment of Homozygous familial hypercholesterolemia (HoFH), a rare genetic disorder where the cholesterol level is extremely high since birth and increases the risk of early cardiovascular disease. By reducing the production of cholesterol, statins can help to lower LDL bad cholesterol and triglyceride levels, while also increasing HDL good cholesterol levels. Atorvastatin (Lipitor) Nursing Considerations and Patient Teaching [Drug Guide], Pharmacology Made Incredibly Easy (Incredibly Easy! These plaques can eventually break off and block arteries, putting patients at risk for other, potentially more fatal conditions like myocardial infarction and stroke. production of cholesterol. High level of lipids and triglyceride is associated with metabolic syndrome consist of insulin resistance, abdominal obesity, hypertension, and proinflammatory and prothrombotic states. Buy cheap Lisinopril online - Hydrochlorothiazide Tablets for Sale Order Lisinopril (Hydrochlorothiazide) No Prescription Ulcerative actinomycosis usually develops in debilitated patients. If your institution subscribes to this resource, and you don't have an Access Profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus. Obtain detailed medical and drug related history including hypersensitivity, possible pregnancy. Do not breast feed while taking this drug. hmg coa reductase inhibitors There's more to see -- the rest of this topic is available only to subscribers. NurseTogether.com does not provide medical advice, diagnosis, or treatment. 3. Action Action Action Drug therapy for elevated cholesterol and lipid levels is meant to be used alongside lifestyle modifications such as dietary modifications, regular exercise, weight and stress management, and smoking cessation for the best results. She has worked in Medical-Surgical, Telemetry, ICU and the ER. GU: erectile dysfunction. Lab tests: Monitor lipid levels within 24 wk after initiation of therapy or upon change in dosage; monitor liver functions St Johns wort, a herbal remedy taken for depression, reduces the amount of atorvastatin in the blood, so it may diminish the effectiveness of atorvastatin therapy. The drug may be put on hold in the event of severe illness or acute injury. Monitor liver function tests, including AST and ALT, before initiating therapy.Atorvastatin is primarily metabolized in the liver. This is because the body makes most cholesterol at night. Our website services and content are for informational purposes only. What is this drug used for? She has more than 10 years of clinical and teaching experience and worked as a licensed Nursing Specialist in JCI-accredited hospitals in the Middle East. Therefore, monitor liver function tests (LFT) and other parameters of liver function regularly, especially in patients with pre-existing liver disease. atorvastatin can increase liver enzyme levels. Inform the patient that he/she can take atorvastatin with or without meals, but preferably with or after meals. Its the active ingredient that is used to make the medication called atorvastatin which is manufactured by various pharmaceutical companies. Check for history of hypothyroidism. being able to get an erection, but not having it last long enough for sex. It is used to slow the progress of heart disease. of alcohol. Increase physical activity. The enzyme that it needs to target is more active at night. 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. Cardiovascular system benefits. Instruct the patient on how to self-administer oral atorvastatin. 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. Some of the drugs that may interact with atorvastatin include: Additionally, atorvastatin may interact with some herbal supplements such as red yeast rice, which contains compounds similar to those found in statins, and can increase the risk of side effects. Liver/Kidney diseases. Use caution during early stages to avoid fatigue of affected muscles, and implement assistive devices (walker, cane, crutches) as needed to prevent falls and assist mobility. Otherwise it is hidden from view. (category X), lactation. It is also used to treat kidney problems in patients with type 2 diabetes and a history of hypertension. Advise the patient on the recommended daily dosage and to avoid taking double doses to make up for any missed dose. EENT: Hoarseness of voice, rhinitis, sinusitis. Its also worth noting that atorvastatin has pleiotropic effects, which means it has multiple actions beyond just reducing cholesterol levels. 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