180 - The Ultimate Guide to Statins: An In-Depth Drug Class Review

HelixTalk - Rosalind Franklin University's College of Pharmacy Podcast

Sean P. Kane, PharmD, BCPS

Health & Fitness, Medications, Rosalindfranklin, Rfums, Pharmacy, Pharmd, Pharmacist, Medicine, Drugs

5 • 644 Ratings

🗓️ 26 March 2024

⏱️ 42 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode, we review the pharmacology, indications, adverse effects, monitoring, and unique drug characteristics of HMG CoA reductase inhibitors (“statins”).

Key Concepts

Statins reduce LDL cholesterol by 20-60% (depending on the dose and statin potency). They have modest favorable effects on HDL and triglycerides. Clinically, statins reduce the risk of major adverse cardiac events by about 30% depending on the statin potency.
There are four main groups of patients who are indicated for a statin: LDL >= 190 mg/dL, diabetes with age 40-75 years with LDL 70-189 mg/dL, those with an elevated 10-year ASCVD risk of > 7.5% (or possibly > 5%), and those who have had an ASCVD event (“secondary prevention”).
Atorvastatin, lovastatin, and simvastatin heavily rely on CYP 3A4 metabolism and tend to be most susceptible to drug interactions compared to the other statins.
When a statin is started, baseline lipid panel and liver function tests should be obtained. After 4-12 weeks, a lipid panel should be repeated. Liver function and creatine kinase testing should only be done if a patient has a symptom (e.g. jaundice, right upper quadrant pain, muscle pain or weakness, dark urine, etc.)

References

Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139(25):e1082-e1143. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000625

Transcript

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0:00.0	Welcome to Helix Talk, an educational podcast for healthcare students and providers covering real-life clinical pearls, professional pharmacy topics, and drug therapy discussions.
0:11.0	This podcast is provided by pharmacists and faculty members at Rosal Franklin University College of Pharmacy.
0:17.0	This podcast contains general information for educational purposes only. This is not professional
0:22.4	advice and should not be used in lieu of obtaining advice from a qualified health care provider.
0:27.2	And now, on to the show.
0:31.2	Welcome to Helix Talk episode 180. I'm your co-host, Dr. Kane. And I'm Dr. Patel.
0:36.2	And the title of today's episode is The Ultimate Guide to Statins, an in-depth drug class review.
0:42.3	So Dr. Patel, today we're talking about statins and everything a clinician needs to know about this really important drug class.
0:47.3	This is really exciting because I teach it, and so it's going to be an additional tool that I can give my students to review on the side.
0:53.3	So thank you for doing this.
0:55.0	Perfect.
0:55.5	Well, why don't we start with just brain and generic names?
0:57.7	And, you know, when I teach really any pharmacotherapy topic, Dr. Patel, I always go through
1:03.2	and I pronounce the brain and generic names because I think it's really important that as
1:06.4	healthcare providers, we call the drug the way it's supposed to be called, right?
1:09.7	Right.
1:15.3	Generically, all the generic entities end in statin.
1:17.7	And then we have different brand names thereafter.
1:18.2	Yep.
1:20.5	So we have a torvastatin, brand name is Lipitor.
1:22.9	Fluvastatin, brand name is Lescal.
1:25.5	Lova statin, brand name is Mevacore.
	...

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