Med Card- Atorvastatin PDF

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Summary

Med Card for Nursing Care Plan- Atorvastatin...

Description

Trade & Generic Names

Pharmacokinetics (absorption, [onset, peak, duration], distribution, metabolism, excretion)

Atorvastatin (Lipitor)

Route

Classification

PO Unknown Half-life: 14 hours.

Therapeutic class: Antilipemics Pharmacologic class: HMG-CoA reductase

Onset

Peak

Duration

1–2 hr

Unknown

inhibitors

Client Order (include dosage, route, & frequency) 40 mg PO daily

Recommended Dosage Range

Adults: Initially, 10 to 20 mg PO daily. May increase based on patient response and tolerance; usual dosage, 10 to 80 mg PO daily.

IV medication administration flow rate & dilution

Side Effects CNS: insomnia. CV: stroke. EENT: nasopharyngitis, pharyngolaryngeal pain. GI: abdominal pain, diarrhea, dyspepsia, flatulence, nausea. GU: UTI. Metabolic: diabetes mellitus. Musculoskeletal: rhabdomyolysis, arthralgia, myalgia, extremity pain, muscle spasms, musculoskeletal pain. Skin: rash Contraindications • Contraindicated in patients hypersensitive to drug and in those with active liver disease or unexplained persistent elevations of transaminase levels. • Some dosage forms contain polysorbate 80, which can cause delayed hypersensitivity reactions. • Use cautiously in patients with hepatic impairment or heavy alcohol use, in patients with inadequately treated hypothyroidism, with other drugs associated with myopathy, and in elderly patients. • Withhold or stop drug in patients at risk for renal failure caused by rhabdomyolysis resulting from trauma; in serious, acute conditions that suggest myopathy; and in major surgery, severe acute infection, hypotension, uncontrolled seizures, or severe metabolic, endocrine, or electrolyte disorders. • Limit use in children to those older than age 10 with homozygous familial hypercholesterolemia. • Dialyzable drug: No. Drug Interactions (include IV compatibility/incompatibility) Amiodarone: May increase risk of severe myopathy or rhabdomyolysis. Avoid use together or decrease atorvastatin dose. Antacids, cholestyramine, colestipol: May decrease atorvastatin level. Separate administration times.

N/A

Boceprevir: May increase atorvastatin level and risk of myopathy and rhabdomyolysis. Atorvastatin dosage shouldn’t exceed 40 mg daily. Colchicine, diltiazem, fibric acid derivatives, nefazodone, niacin, protease inhibitors, verapamil: May decrease metabolism of HMG-CoA reductase inhibitors, increasing toxicity. Monitor patient for adverse effects and report unexplained muscle pain. Cyclosporine, tacrolimus, telaprevir, tipranavir plus ritonavir: May increase statin level and risk of myopathy and rhabdomyolysis. Avoid use together. Darunavir and ritonavir, fosamprenavir, fosamprenavir and ritonavir, saquinavir and ritonavir: May increase atorvastatin level and risk of myopathy and rhabdomyolysis. Atorvastatin dosage shouldn’t exceed 20 mg daily. Digoxin: May increase digoxin level. Monitor digoxin level and patient for evidence of toxicity. Grapefruit juice: May increase drug levels when consumed in large quantities, increasing risk of adverse reactions. Discourage use together.

Antidote (include dosage, route, & frequency) Uses/Indications (individualize for client) In patients with clinically evident CAD, to reduce risk of nonfatal MI, fatal and nonfatal strokes, angina, HF, and revascularization procedures Mechanisms of Action

Inhibits HMG-CoA reductase, an early (and rate-limiting) step in cholesterol biosynthesis.

Nursing Implications (including client teaching) • Patient should follow a standard cholesterol-lowering diet before and during therapy. • Before treatment, assess patient for underlying causes for hypercholesterolemia and obtain a baseline lipid profile. Obtain periodic LFT results and lipid levels before starting treatment and at 4 and 12 weeks after initiation, or after an increase in dosage and periodically thereafter. • Watch for signs of myositis and myopathy (unexplained muscle pain, tenderness, weakness, malaise, dark urine, fever). Drug may need to be discontinued. • Look alike-sound alike: Don’t confuse atorvastatin with atomoxetine. Don’t confuse Lipitor with Loniten, Levatol, or Zyrtec. • Teach patient about proper dietary management, weight control, and exercise. Explain their importance in controlling high fat levels. • Warn patient to avoid alcohol. • Tell patient to inform prescriber of all adverse reactions, such as muscle pain, malaise, and fever. • Advise patient that drug can be taken at any time of day, without regard for meals. • Alert: Tell female patient to stop drug and notify prescriber immediately if she is or may be pregnant or if she’s breastfeeding....