In (zocor)

INDEX Generic Name simvastatin

Trade Name Zocor

Peak Onset unknown unknown Why is your patient taking this medication?

NURS 2236 Clinical Form 3: Clinical Medications Worksheet (You will need to made additional copies of these forms) Classification Dose Route Time/Frequency lipid-lowering agents 5-10mg PO Daily/evening

Duration unknown

Mechanism of action and indications Adjunct to dietary therapy in the management of primary hypercholesterolemia and mixed dyslipidemias Reduction of lipids/chlesterol reduces the risk of MI and stroke, and decreases the need for bypass procedures/ angioplasty. Lowering of total LDL cholesterol, Increase HDL and decrease VLDL cholesterol and triglycerides. Slowing of progression of coronary artery disease with resultant decrease in MI/Stroke and need for myocardial revascularization Interactions with other patient drugs, OTC, or herbal medicines (ask patient specifically) CYP3A4 inhibitors, bile acid sequestrants, amiodarone cyclosporine, gemfibrozil, clofibrate, diltiazem verapamil, erythromycin clarithromycin telithromycin, nefazodone, niacin, azole, antifungal agents, nelfinavir, ritonavir ( (combined with clofibrate or gemfibrozil), warfarin propranolol, saquinavir, St. John's wort, grapefruit juice (more than 1 qt/day) Nursing Process - Assessment (Pre-administration assessment) Vital Signs Dietary history (fats), Ophthalmic exams,

For IV meds, compatability with IV drips and/or solutions

Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity, Cross-sensitivity among agents, sepsis, acute hypotension, major surgery, trauma, severe metabolic disturbances, endocrine or electrolyte disorders, uncontrolled seizures, active liver disease, pregnancy, lactation, use of gemfibrozil or azole use of nelfinavir or ritonavir, alcohol, renal impairment, visual, myopathy,Asian Common side effects dizziness, headache, insomnia, weakness, rhinitis, lovastatin: blurred vision, bronchitis, abdominal cramps, constipation, diarrhea, flatus, heartburn, altered taste, drug-induced hepatitis, dyspepsia, elevated liver enzymes, nausea, pancreatitis, impotence, rhabdomyolysis, arthralgia, arthritis, myalgia, myositis Lab value alterations caused by medicine

Be sure to teach the patient the following about this medication Don't dring more than 1 qt/day grapefruit, use meds in conjuction with diet. exercise and stop smoking, notify physician of muscle pain, tenderness, or weakness occurs (especially with fever or malaise). Wear sunscreen and protective clothing, notify if pregnant, follow-up exams.

Assessment Why would you hold or not give this med? Muscle tenderness, high CPK levels, myopathy

Evaluation Check after giving Decrease in serum LDL, VLDL, and total cholesterol levels. Increase in HDL cholesterol levels Decrease in triglyceride levels Slowing of the progression of coronary artery disease