Lovastatin

1. Pharmacokinetics

1.1. High first pass effect

1.2. uses CYP 3A4 system

1.3. active metabolite formed

1.4. highly protein bound

2. Pharmacodynamics

2.1. Increase vasodilation

2.2. Increase re-endothelialization

2.3. Inhibit inflammation

2.4. Stabilize Plaque

2.5. Decrease thrombogenicity

2.6. Increase bioavailability of Nitrice Oxide

2.7. Inhibits HMG-CoA reductase

2.7.1. Decreases LDL

2.7.2. Increases HDL

3. Pharmacotherapeutics

3.1. Hypercholesteremia

3.2. Secondary treatment of coronary events

3.2.1. MI

3.2.2. Stroke

4. Contraindicatoin

4.1. Liver Disease

4.2. Pregnancy X

4.3. Drugs that use the CYP3A4 system, hypersensitivity to lovastatin

4.4. Serum transaminase elevations

5. Nursing Management

5.1. Diet

5.1.1. Decrease

5.1.1.1. saturated fats

5.1.1.2. trans fats

5.1.1.3. cholesterol

5.1.1.4. weight

5.1.2. increase

5.1.2.1. plant staols

5.1.2.2. insoluble fiber

5.1.3. Avoid ETOH, decreases risk of hepatotoxicity. No grapefruit juice

5.2. Adverse Effects

5.2.1. Myopathy

5.2.2. Rhabdomyoloysis

5.2.3. HA, N/D, constipation, abdominal pain

5.2.4. Increase liver enzymes, liver failure, autoimmune disease, systemic lupus erythematosus

5.3. Complications

5.3.1. HTN

5.3.2. Artherosclerosis

5.3.3. CVA

5.3.4. CHD

5.3.5. MI

5.4. Multiple drug interactions, consult physical before adding anything to your regimen