PHRM 211 Lecture Notes - Lecture 5: Grapefruit Juice, Cyp3A4, Rosuvastatin
Document Summary
Not well understood (not cyp: dyslipidemia (part 3) Amiodarone, ccbs (diltiazem, verapamil, amlodipine), colchicine, cyclosporine. Rosuvastatin + magnesium/aluminum antacids separate dose by 2 hr. Hemoglobin a1c, tsh, scr (if clinically indicated) No rct has targeted a specific ldl-c. Higher intensity statin therapy superior to lower intensity. Ldl-c associated with risk of cv events. May aid clinicians in optimizing statin therapy. Ldl-c < 2 mmol/l or > 50% apob < 0. 8 g/l or or primary prevention reduction in ldl-c non-hdl-c < 2. 6 mmol/l. Ldl-c by 40-70% with statin therapy. Adverse effects : injection site reactions, nasopharyngitis, n/d. Outcomes (evolocumab): ldl-c 2. 4 0. 8 mmol/l. Patients with a recent acs on statin therapy. Outcomes (alirocumab): ldl-c 2. 2 1. 4 mmol/l. Ldl-c by 18% with statin therapy. Contraindications : active hepatic disease or unexplained liver enzyme elevation (with statins), hypersensitivity, pregnancy/lactation. Adverse effects : fatigue, sinusitis, urti, diarrhea, increased liver enzymes (with statins), arthralgias.
