ACTIVE LEARNING TEMPLATE: Medication
Kaitlyn Ranieri
STUDENT NAME _____________________________________
Atorvastatin (Lipitor)
MEDICATION __________________________________________________________________________ REVIEW MODULE CHAPTER ___________
Antilipidemic
Statins / HMG-CoA reductase inhibitor
CATEGORY CLASS ______________________________________________________________________
PURPOSE OF MEDICATION
Expected Pharmacological Action Therapeutic Use
Inhibits HMG-CoA reductase enzyme, which Adjunct in primary hypercholesterolemia (types Ia, Ib),
dysbetalipoproteinemia, elevated triglyceride levels;
reduces cholesterol synthesis, prevention of cardiovascular disease by reduction of heart risk
high doses lead to plaque regression in those with mildly elevated cholesterol
Complications Medication Administration
CNS: Headache, asthenia, Lou Gehrig’s disease (ALS) • Adult: PO 10-20 mg daily, usual range
EENT: Lens opacities GI: Abdominal cramps, constipation, diarrhea, heartburn, nausea, dyspepsia, flatus,
liver dysfunction, pancreatitis, increased serum transaminase 10-80 mg, dosage adjustments may be
GU: Impotence made in 2-4 wk intervals, max 80 mg/day;
INTEG: Rash, pruritus, alopecia, photosensitivity (rare) patients requiring .45% ↓ in LDL may be
MISC: Hypersensitivity
MS: Myalgia, rhabdomyolysis, arthralgia started at 40 mg daily
RESP: Pharyngitis, sinusitis • Forms: Tabs 10, 20, 40, 80 mg
• Administer total daily dose at any time of
day
• Store in cool environment in airtight, light
resistant container
Contraindications/Precautions
CI: Pregnancy X, breastfeeding, hypersensitivity, active
liver disease Nursing Interventions
P: Past liver disease, alcoholism, severe acute infections,
• Hypercholesterolemia: assess nutrition: fat, protein,
trauma, severe metabolic disorders, electrolyte imbalance carbohydrates; Nutritional analysis by dietitian before
Tx; Assess for muscle pain, tenderness; obtain CPK if
these occur, discontinue; monitor triglycerides,&
cholesterol at baseline and throughout Tx; if ↑LDL &
VLDL, discontinue • Monitor (1) bowel pattern daily;
diarrhea may be a problem (2) liver function studies
q1-2mo during first 1½ yr of treatment; AST, ALT,
Interactions liver function tests may ↑ (3) renal studies in pts w/
compromised renal system: BUN, I&O ratio, creatinine
RX: Clofibrate, cycloSPORINE, erythromycin, gemfibrozil, niacin: ↑risk of • Assess eyes via ophthalmic exam 1 mo after Tx
rhabdomyolysis; Colestipol: ↓ action of atorvastatin. Antifungals (azole): begins, annually
possible rhabdomyolysis. Contraceptives (oral): ↑ levels. Digoxin: ↑ action of
digoxin; Erythromycin: ↑ levels of atorvastatin, Warfarin: ↑ action of warfarin
HERB: St. John’s wort: ↓effect. FOOD: Grapefruit juice: possible toxicity; Oat
bran may ↓ effectiveness
Client Education
• Compliance: needed for positive results, not to
double doses • ↓Risk factors: high-fat diet, smoking,
alcohol consumption, absence of exercise • Notify
Evaluation of Medication Effectiveness prescriber if GI symptoms of diarrhea, abdominal or
epigastric pain, nausea, vomiting; chills, fever, sore
throat; muscle pain, weakness occur • Tx will take
↓ cholesterol levels and LDLs, ↑ HDLs several years • Blood work and eye exam necessary
during treatment • Do not take if pregnant
(pregnancy X) or breastfeeding • Stay out of the
Improved HDL:LDL ratio sun, use protective clothing, or use sunscreen to
prevent photosensitivity (rare)
ACTIVE LEARNING TEMPLATES THERAPEUTIC PROCEDURE A7