This literature reviews one of the best selling prescription drugs ever in history, the statins. More specifically, atorvastatin (Lipitor). Perhaps this is because the diet of the general population seems to slowly become more unhealthy by the day. After all, heart disease holds the number one spot for mortality rates. Statins are classified in the broad spectrum "heart drugs" category. Perhaps, this also contributes to the fact they are so widely used.
Those that have ever taken a pharmacology course before know that statin drugs are given to lower cholesterol. Their chemical class is HMG-CoA reductase inhibitors. This means they inhibit the HMG-CoA reductase enzyme which, in turn, reducing cholesterol synthesis. As many already know, the medically correct term for "high cholesterol" is hyperlipidemia. Hyperlipidemia, along with hypertension, hyperglycemia, and smoking all severly increase the risk of developing heart disease, and more importantly, acquiring a stroke. Therefore, statin drugs are a very important part of lowering one key factor that could lead to a fatal heart condition.
Much of this article focuses on the adverse effects and side effects of statins. A few of these include muscle pains, rhabdomyolysis, cognitive loss, neuropathy, pancreatic and hepatic dysfunction, as well as sexual dysfunction. As many may already know, by far the most common reported adverse effects of statin drugs are severe generalized muscle pains and rhabdomyolysis. For a quick refresher, rhabdomyolysis is a condition in which skeletal muscle is broken down, releasing muscle enzymes and electrolytes from inside the muscle cells. The severity of these adverse effects are proved in this literature to be directly related to the dose effect, drug interactions, and genetic predispositions. The drugs known to increase muscle pain and rhabdomyolysis include drugs that increase the potency of statins, such as antifungals, cyclosporine, erythromycin, niacin, gemfibrozil, clofibrate, and CPY3A4 inhibitors. This is because these drugs often inhibit the cytochrome P450 (CYP) 3A4 system. Patients with metabolic vulnerability or dysfunction, such as those with metabolic symdrome or thyroid disease, are also at an increased risk for developing more severe muscle pains than others who lack these genetic predispositions.
This literature also reports how very little physicians are actually aware of the adverse effects these statins produce in the patients to who they have been prescribing. This is a vital factor when considering patient compliance. If these statin drugs cause patients chronic muscle pain, eventually they will cease to take them. They may or may not report this to their doctor.
In conclusion, doctors should be more informed about the drugs they are prescribing patients. Nurses should be more informed on the serious side and adverse effects of these drugs. They should do more patient education about adverse effects and when to report them. This will increase the quality of patient care, patient compliance, communication between patients and their health care providers, and reduce patient morbidity rates.
More of this...
Will lead to more of this...
And less of this...
[Statins]...
Posted by: Julia James
Julia this is stellar work. I like that you emphasized the importance of the nurse doing education on these drugs. You are a ROCKSTAR!!!
ReplyDeleteHi Julia!
ReplyDeleteI could not agree more with you on the take of this article.
Ever since one of many fantastic teachers a while back told my class his story about statins, I do not like them. I like that you pointed out that many in the healthcare field do not understand the severity of the side effects nor the importance of teaching which can decrease the risk of noncompliance resulted by the rather severe side effects associated with a medication such as Lipitor.
It would be interesting to see why so many prescribers still fall back on statins even though the literature shows the potential adverse effects that accompany such a medication when there are many other options to lower cholesterol including omega-3 fatty acids and healthy eating. Is it because its produced by a major pharmaceutical company and therefore the default medication that is thought of when a health care provider develops a treatment plan? All of those possible factors again circle around to how important patient education is to at least alert to the possible side effects caused by such a medication.
With that said, I completely agree with Ms. P! Fantastic work and thank you for such a great review!! ��������
Good Afternoon Julia,
ReplyDeleteThank you for sharing this article and providing a review on them. All healthcare professionals I hope are aware of abundance of client taking these medications. You mentioned the adverse effects and side effects associated with statins, stating the two main aggravating culprits being muscle pain and rhabdomyolysis. Like you mentioned when these side effects are paired with metabolic syndrome, thyroid disorders, unhealthy diets, and sedimentary lifestyles; it is understandable how clients could come to the conclusion that stoping the medication would at least physically enhance the way they feel. In general I believe we have been taught since we were young that medication was supposed to make us feel better. When your health care professional prescribes a medication possibly for a condition that was not bothering you in the first place and pain is associated with it, goes against what we believe is how medicine is supposed to work. If not addressed before hand this could lead to mistrust in the health care professional, a deterioration in the therapeutic relationship between care-giver and care-reciever, and non-compliance with therapeutic regimes all together. Which is why I agree with you, we must educate every one of our clients on statins, and not just the benefits, but especially the side effects they should expect. Then go the extra step and educate on alternative therapies that could help with the discomfort caused by the medications.
With pharmacological therapies advancing and growing each day, it is hard for anyone in the healthcare field to keep up. Physicians, physicians assistants, and nurse practitioners are approached by relentless drug representatives offering new options and incentives to prescribe their products. This not only leads to time being taken away from the HCP and client interaction, it puts pressure on the HCP because at the end of the day he wants to do what it best for the client. I am not taking up for the lack of educating and awareness that HCP's provide to clients, but insurance and government regulations are also increasing the demands of them. I am sure if anyone reading has been to a doctors office lately, you probably waited at least an hour past your scheduled appointment to get in a room, to wait another thirty minutes to see a HCP for fifteen minutes. In addition HCP's have been prescribing statins for a long time, they are boring, nothing exciting and new about them. This dusty stigma does them no justice. Everyone wants to talk about the new and exciting treatment. But what about our old friend the Statin? I know they have one advocate, Ms. James.
So, as future nurses we must join Ms. James, and once again pick up where someone else has fallen short. We must advocate, educate, and encourage our clients. Because we would not have made it this far if we did not care, and that is what nursing is all about caring...and washing your hands.
Thanks for sharing,
Shane Howard SN, FSCC