PHRM3011 Lecture Notes - Lecture 12: Chest Pain, Hypercholesterolemia, Felodipine
Document Summary
Resins: stop if ck > 10x normal. 50% of max dose = >80% ldl lowering. Some evidence of high dose benefit in coronary heart disease. Di"s simva and atorva metabolised via cyp3a4 fluva metabolised by cyp2c9 major, cyp3a4 minor. Prava and rosuva nor metabolised by cyp enzymes. Inhibitors of cyp3a4: clarithromycin, itraconazole, ^ simva and atorva levels, ^ risk of myopathy and rhabdomyloysis. Inducers of cyp3a4: carbamazepine, st johns wart, decrease simva and atorva levels, decrease effectiveness. Cyclosporin, genfibrozil/fenofibrate, nicotinic acid: all increase risk of myopathy and rhabdomyolysis. Warfarin: ^ inr simva, fluva, rosuva. Mixed hyperlipidaemia itch associated with jaundice due to decreased bile salt outflow. Binds other drugs separate dosess (take other drugs 4-6hrs apart) Gemfibrozil: 600mg bd fenofibrate, 145mg d, decrease dose in reannly impaired. Moa - decrease production and ^ clearance of lipoproteins (tgs) Nicotinic acid statins - ^ risk of myopathy or rhabdomyolysis. Moa - not sure think decrease production in liver.
