Clinical Medications Worksheets Generic Name

atorvastatin calcium

Trade Name
Lipitor

Dose -Antihyperlipidemic Initially, 10 mg PO once

-HMG-CoA reductase inhibitor daily without regard to meals; for maintenance, 1080 mg PO daily. May be combined with bile acidbinding resin. (20mg)

Classification

Route
PO

Time/frequency
0900

Bioavailability 14%

T1/2= 14hr

Duration
unknown

For IV meds, compatibility with IV drips and /or solutions Nursing Implications (what to focus on) Contraindications/warnings/interactions
Contraindicated with allergy to atorvastatin, fungal byproducts, active liver disease or unexplained and persistent elevations of transaminase levels, pregnancy, lactation. Use cautiously with impaired endocrine function.

Mechanism of action and indications (Why med ordered)

Inhibits HMG-CoA reductase, the enzyme that catalyzes the first step in the cholesterol synthesis pathway, resulting in a decrease in serum cholesterol, serum LDLs (associated with increased risk of CAD), and increases serum HDLs (associated with decreased risk of CAD); increases hepatic LDL recapture sites, enhances reuptake and catabolism of LDL; lowers triglyceride levels. Adjunct to diet in treatment of elevated total cholesterol, serum triglycerides, and LDL cholesterol in patients with primary hypercholesterolemia (types IIa and IIb) and mixed dyslipidemia, primary dysbetalipoproteinemia, and homozygous familial hypercholesterolemia whose response to dietary restriction of saturated fat and cholesterol and other nonpharmacologic measures has not been adequate To increase HDL-C in patients with primary hypercholesterolemia and mixed dyslipidemia Adjunct to diet to treat elevated serum triglyceride levels Adjunct to diet in treatment of boys and postmenarchal girls ages 1017 with heterozygous familial cholesterolemia if diet alone is not adequate to control lipid levels and LDL-C levels are > 190 mg/dL or if LDL-C level is > 160 mg/dL and there is a family history of premature CV disease or the child has two or more risk factors for the development of coronary disease Prevention of CV disease in adults without clinically evident coronary disease but with multiple risk factors for CAD such as age > 55 yr, smoking, hypertension, low HDL-C, family history of early CAD; to reduce the risk of MI and risk for revascularization procedures and angina

Common side effects

CNS: Headache, asthenia GI: Flatulence, abdominal pain, cramps, constipation, nausea, dyspepsia, heartburn, liver failure Respiratory: Sinusitis, pharyngitis Other: Rhabdomyolysis with acute renal failure, arthralgia, myalgia

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) Antacids Decrease Atorvastatin Levels Erythromyacin increases Atorvastatin Levels

Lab value alterations caused by medicine

CPK (due to Myalgia) *if applicable*

Be sure to teach the patient the following about this medication

Take this drug once a day, at about the same time each day, preferably in the evening; may be taken with food. Do not drink grapefruit juice while taking this drug. Institute appropriate dietary changes. Arrange to have periodic blood tests while you are taking this drug. Alert any health care provider that you are on this drug; it will need to be discontinued if acute injury or illness occurs. Do not become pregnant while you are on this drug; use barrier contraceptives. If you wish to become pregnant or think you are pregnant, consult your health care provider. You may experience these

Nursing Process- Assessment (Pre-administration assessment)

History: Allergy to atorvastatin, fungal byproducts; active hepatic disease; acute serious illness; pregnancy, lactation Physical: Orientation, affect, muscle strength; liver evaluation, abdominal examination; lipid studies, LFTs, renal function tests

Assessment Why would you hold or not give this med?

Allergy

Evaluation
Decrease in LDL , VLDL, Triglycerides Decrease in Total Cholesterol