indications

For management as an adjunct to diet to reduce elevated total-C, LDL-C, apo B, and TG levels in patients
with primary hypercholesterolemia and mixed dyslipidemia.

Adverse:

Headache, flatulence, diarrhoea, nausea, vomiting, anorexia, xerostomia, angioedema, myalgia,

rash/pruritus, alopecia, allergy, infection, chest pain.
Potentially Fatal: Thrombocytopenia. Rhabdomyolysis with acute renal failure

        CNS: Headache,         GI: Flatulence, abdominal pain, cramps, constipation, nausea,
dyspepsia, heartburn, liver failure

        Respiratory: Sinusitis, pharyngitis

- chest pain;
- diarrhea;
- difficulty breathing or swallowing;
- difficulty falling asleep or staying asleep;
- dizziness;
- extreme tiredness;
- fever;
- flu-like symptoms;
- frequent urge to urinate;
- headache;
- hives;
- hoarseness;
- itching;
- joint pain;
- lack of energy;
- loss of appetite;
- muscle pain, tenderness, or weakness;
- nausea;
- pain during urination;
- pain in the upper right part of the stomach;
- rash;
- sore throat;
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs;
- swelling of the hands, feet, ankles, or lower legs;
- unusual bleeding or bruising;
- upper respiratory infection;
- yellowing of the skin or eyes;

Contraindications
Hypersensitivity, active liver disease or unexplained persistent elevations of serum transaminase,
porphyria, pregnancy, lactation.

Mechanism of Action

Atorvastatin is a selective, competitive inhibitor of HMG-CoA reductase, the rate-limiting

enzyme that converts 3-hydroxy-3-

methylglutaryl-coenzyme A to mevalonate, a precursor of sterols, including cholesterol.

Cholesterol and triglycerides circulate

in the bloodstream as part of lipoprotein complexes. With ultracentrifugation, these complexes

separate into HDL (high-density

lipoprotein), IDL (intermediate-density lipoprotein), LDL (low-density lipoprotein), and VLDL

(very-low-density lipoprotein)

fractions. Triglycerides (TG) and cholesterol in the liver are incorporated into VLDL and
released into the plasma for delivery to

peripheral tissues. LDL is formed from VLDL and is catabolized primarily through the high-
affinity LDL receptor. Clinical and

pathologic studies show that elevated plasma levels of total cholesterol (total-C), LDL-
cholesterol (LDL-C), and apolipoprotein B

(apo B) promote human atherosclerosis and are risk factors for developing cardiovascular
disease, while increased levels of HDL-C

are associated with a decreased cardiovascular risk.

Nursing Alert

Check for liver function before giving atorvastatin. (HMG-CoA reductase inhibitors, like some
other lipid-lowering therapies, have been associated with biochemical abnormalities of liver
function.)
Do not take LIPITOR if you:

• are pregnant or think you may be pregnant, or are planning to become pregnant. Lipitor may
harm your unborn baby. If you get

pregnant, stop taking LIPITOR and call your doctor right away.

• are breast feeding. LIPITOR can pass into your breast milk and may harm your baby.

• have liver problems

• are allergic to LIPITOR or any of its ingredients. The active ingredient is atorvastatin. See the
end of this leaflet for a complete list

of ingredients in LIPITOR.

Nsg. Consideration.

Prior to administration

-obtain complete health history including allergies.

-assess baseline liver function tests, lipid studies, and pregnancy test in women of child bearing
age.

-assess for history of liver disease, muscle disease

-obtain pt’s drug history including use of over the counter medications that might affect liver fxn
or have interactions and assess allergies.

-monitor for concurrent alcohol use

-encourage smoking cessation. (smoking may dec. HDL lvls and thereby counteract effects of
medication)

Evaluate reports of vision changes (drug may cause photosensivity)