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Nursing Notes and Community
Drug Name Dosages Therapeutic Actions Indications Adverse effects Contraindications Nursing considerations
atorvastatin ADULTS Inhibits HMG-CoA Adjunct to diet in CNS: Contraindicated CLINICAL ALERT!
calcium Initially, 10 mg reductase, the treatment of Headache, with allergy to Name confusion has been
(ah tor' va PO once daily enzyme that elevated total asthenia atorvastatin, reported between written
stah tin) without regard catalyzes the first cholesterol, serum fungal orders for Lipitor
Lipitor to meals; for step in the triglycerides, and GI: byproducts, (atorvastatin) and Zyrtec
maintenance, cholesterol LDL cholesterol in Flatulence, active liver (certirizine). Use extreme
Pregnancy 1080 mg PO synthesis pathway, patients with primary abdominal disease or caution.
Category X daily. May be resulting in a hypercholesterolemi pain, cramps, unexplained and
combined with decrease in serum a (types IIa and IIb) constipation, persistent Assessment
Drug bile acid cholesterol, serum and mixed nausea, elevations of History: Allergy to
classes binding resin. LDLs (associated dyslipidemia, dyspepsia, transaminase atorvastatin, fungal
Antihyper with increased risk primary heartburn, levels, byproducts; active hepatic
lipidemic PEDIATRIC of CAD), and dysbetalipoproteine liver failure pregnancy, disease; acute serious
HMG- PATIENTS 1017 increases serum mia, and lactation. illness; pregnancy, lactation
CoA YR HDLs (associated homozygous familial Respiratory:
Physical: Orientation, affect,
reductase Initially, 10 mg with decreased risk hypercholesterolemi Sinusitis, Use cautiously muscle strength; liver
inhibitor PO daily. of CAD); increases a whose response to pharyngitis with impaired evaluation, abdominal
Maximum, 20 hepatic LDL dietary restriction of endocrine examination; lipid studies,
recapture sites, saturated fat and Other: function.
mg/day; do not LFTs, renal function tests
enhances reuptake cholesterol and other Rhabdomyoly
change dose
and catabolism of nonpharmacologic sis with acute
of intervals < 4 Interventions
LDL; lowers measures has not renal failure,
wk. Obtain LFTs as a baseline
triglyceride levels. been adequate arthralgia,
myalgia and periodically during
To increase HDL-C therapy; discontinue drug if
in patients with AST or ALT levels increase
primary to 3 times normal levels.
hypercholesterolemi WARNING: Withhold
a and mixed atorvastatin in any acute,
dyslipidemia serious condition (severe
infection, hypotension,
Adjunct to diet to major surgery, trauma,
treat elevated serum severe metabolic or
triglyceride levels endocrine disorder,
seizures) that may suggest
Adjunct to diet in myopathy or serve as risk
treatment of boys factor for development of
and postmenarchal renal failure.
girls ages 1017
with heterozygous Ensure that patient has tried
familial cholesterol-lowering diet
cholesterolemia if regimen for 36 mo before
diet alone is not
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Nursing Notes and Community
adequate to control beginning therapy.
lipid levels and LDL-
C levels are > 190 Administer drug without
mg/dL or if LDL-C regard to food, but at same
level is > 160 mg/dL time each day.
and there is a family
history of premature Atorvastatin may be
CV disease or the combined with a bile acid
child has two or binding agent. Do not
more risk factors for combine with other HMG-
the development of CoA reductase inhibitors or
coronary disease fibrates.

Prevention of CV Consult dietitian about low-


disease in adults cholesterol diets.
without clinically
evident coronary WARNING: Ensure that
disease but with patient is not pregnant and
multiple risk factors has appropriate
for CAD such as age contraceptives available
> 55 yr, smoking, during therapy; serious fetal
hypertension, low damage has been
HDL-C, family associated with this drug.
history of early CAD;
to reduce the risk of Teaching points
MI and risk for Take this drug once a day,
revascularization at about the same time each
procedures and day, preferably in the
angina evening; may be taken with
food. Do not drink grapefruit
juice while taking this drug.
Institute appropriate dietary
changes.

Arrange to have periodic


blood tests while you are
taking this drug.

Alert any health care


provider that you are on this
drug; it will need to be
discontinued if acute injury
or illness occurs.
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Nursing Notes and Community
Do not become pregnant
while you are on this drug;
use barrier contraceptives. If
you wish to become
pregnant or think you are
pregnant, consult your
health care provider.

You may experience these


side effects: Nausea (eat
frequent small meals);
headache, muscle and joint
aches and pains (may
lessen over time).

Report muscle pain,


weakness, tenderness;
malaise; fever; changes in
color of urine or stool;
swelling.

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