USE OF STATINS IN MANAGEMENT OF HYPERLIPIDEMIA 2

Use of Statins in Management of Hyperlipidemia and the Nursing Implications

Hyperlipidemia is a medical condition characterized by presence in the blood of
abnormally high levels of lipoproteins (Branstetter et al. (2015). Lipoproteins, particularly low
density lipoproteins, are responsible for carrying cholesterol to cells. Thus, elevated levels of
lipoproteins lead to correspondingly high cholesterol levels (Branstetter et al. (2015). Given
strong evidence linking high cholesterol levels with coronary heart disease, it is important to
effectively manage hyperlipidemia.

For management of hyperlipidemia, patients have many drug options to choose from. The
most common one is statins (Branstetter et al. (2015). Also referred to as HMG-CoA reductase
inhibitors, this group of medications is the most commonly used drug in management of
hyperlipidemia. Statins that are most commonly prescribed include Crestor (rosuvastatin),
Pravachol (pravastatin), Lipitor (atorvastatin), Zocor (simvastatin), and Mevacor (lovastatin)
(Branstetter et al. (2015). Compared to other drugs used for hyperlipidemia, these medications
are highly effective. When used properly it can reduce levels of low density lipoproteins by up to
60% (Branstetter et al. (2015). They manage this reduction by slowing the production of the
proteins as well as boosting the ability of the liver to remove them from the bloodstream
(Branstetter et al. (2015). They also reduce the amount of cholesterol that is absorbed in the
intestines (Branstetter et al. (2015).

Though effective they are, they are not without side effects. The two main side effects are
myopathy (muscle pain) and liver toxicity (Gulum & Hume, 2015). These side effects have
nursing implications. Even though a patient may experience myopathy even when using statins
alone, its risk increases significantly when the patient takes the medication in combination with

USE OF STATINS IN MANAGEMENT OF HYPERLIPIDEMIA 3
niacin (nicotinic acid) or fibrate such as fenofibrate (Gulum & Hume, 2015). Myopathy can also
occur when the patient taking statins suffers from either renal disease or diabetes (Gulum &
Hume, 2015).

For liver toxicity, the main causes are taking high statin dose or taking statin in
combination with a drug that is potentially hepatotoxic. An example of such drug is
acetaminophen. Combining statin with alcohol may also lead to liver toxicity (Gulum & Hume,
2015).

Given these risks, it is important to ask the patient about all the other drugs that they are
using before prescribing statin to them. In addition, patients who are on medications that
cytochrome P450 pathway of the liver metabolizes should be encouraged to reduce their need for
statins through regular exercise, quitting alcohol and smoking, and taking a healthy diet (Gulum
& Hume, 2015). For liver toxicity monitoring, it is important that patients go for regular testing
of liver functions for possible toxic effects on them (Gulum & Hume, 2015).

USE OF STATINS IN MANAGEMENT OF HYPERLIPIDEMIA 4

References

Branstetter, D. N. P., Laurie, M., Main, M. E., & Bragg-Underwood, D. N. P. (2015). Practice
matters: Screening and monitoring hyperlipidemia. International Journal of Faith
Community Nursing, 1(2), 21.
Gulum, A. H., & Hume, A. L. (2015). Statins: An update on clinical issues and selected adverse
effects. The Journal for Nurse Practitioners, 11(3), 287-294.