Brand Name: Crestor Generic Name: Rosuvastatin Indications: Adjunct to dietary therapy in the management of primary hypercholesterolemia and mixed dyslipidemias. Reduction of lipids/cholesterol reduces the risk of MI and stroke sequelae (primary prevention and secondary prevention) nd decreases the need for bypass procedures/angioplasty. Drug Classification: Lipid-lowering agents, HMG-CoA reductase inhibitors Mechanism of Action: Inhibit an enzyme, 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, which is responsible for catalyzing an early step in the synthesis of cholesterol. Therapeutic effects: Lowering of total and LDL cholesterol; Increase HDL and decrease VDDL cholesterol and triglycerides; Slowing of the progression of coronary artery disease with resultant decrease in MI/stroke and need for myocardial revascularization. Dosage: Adult: 10 mg od initially (range 5-20 mg); dose may be adjusted at 2-4 wk intervals; some patients may require up to 40 mg/day; concurrent cyclosporine therapy – not to exceed 5 mg od; concurrent gemfibrozil therapy – not to exceed 10 mg od. Special Precautions: History of liver disease or significant alcohol use/abuse; patients with Asian ancestry (may have high blood levels); renal impairement, advanced age or hypothyroidism; visual disturbances; myopathy; women of childbearing age; children <8 yr. Pregnancy Risk Category: X Adverse Reactions:
CNS: dizziness, headache, insomia, weakness EENT: rhinitis, Resp: Bronchitis GI: abdominal cramps, constipation, diarrhea, flatus, heartburn, altered taste, drug-induced hepatitis, dyspepsia, elevated liver enzymes, nausea, pancreatitis GU: impotence, Derm: rashes, pruritus MS: Rhabdomyolysis, arthralgia, arthritis, myalgia, myositis Misc: hypersensitivity reactions. Contraindications: Hypersensitivity, cross-sensitivity among agents may occur; sepsis, acute hypotension, major surgery, trauma, severe metabolic disturbances, endocrine or electrolyte disorders, uncontrolled seizures; active liver disease; pregnancy or lactation; concurrent use of gemfibrozil or azole antifungals. Forms: Tablets – 5 mg, 10 mg, 20 mg, 40 mg Nursing Responsibilities: Obtain a dietary history, especially with regard to fat consumption. Opthalmic exams are recommended before and yearly during therapy. If patients develop muscle tenderness during therapy, monitor CPK levels. May cause thyroid function test abnormalities. Instruct patient to notify health care professionals if unexplained muscle pain, tenderness, or weakness occurs, especially if accompanied by fever or malaise. Instruct client to wear sunscreen and protective clothing to prevent photosensitivity reactions.