What is the primary action of statins and a major adverse effect to monitor?

What is the primary action of statins and a major adverse effect to monitor?

• A. Inhibit HMG-CoA reductase, reducing cholesterol synthesis; monitor for myopathy and elevated liver enzymes
• B. Inhibit cholesterol absorption in the intestine; monitor for constipation
• C. Activate PPAR-alpha to decrease triglycerides; monitor for pancreatitis
• D. Increase cholesterol excretion via bile; monitor for jaundice

Answer: (B)

Statins lower cholesterol by blocking the liver’s HMG-CoA reductase enzyme, the step that starts cholesterol production. By inhibiting this enzyme, the liver makes less cholesterol, which causes more LDL receptors to appear on liver cells and pull LDL cholesterol out of the blood, lowering overall blood cholesterol levels. A major adverse effect to monitor is muscle damage (myopathy, and in some cases rhabdomyolysis) and potential liver injury, shown by rising liver enzymes. Patients may report muscle aches or weakness, and severe cases can involve dark urine or other signs of liver stress, so liver function tests are often checked during therapy. Other lipid-lowering drug classes work differently, which is why those options aren’t correct. Inhibiting cholesterol absorption in the intestine describes a drug that reduces gut absorption (not how statins work) and can be associated with constipation. Drugs that activate PPAR-alpha to decrease triglycerides are fibrates and have a different risk profile, including pancreatitis in some scenarios and potential muscle effects when used with statins. Drugs that increase cholesterol excretion via bile are bile acid sequestrants and have distinct GI effects and nutrient absorption considerations.

Statins lower cholesterol by blocking the liver’s HMG-CoA reductase enzyme, the step that starts cholesterol production. By inhibiting this enzyme, the liver makes less cholesterol, which causes more LDL receptors to appear on liver cells and pull LDL cholesterol out of the blood, lowering overall blood cholesterol levels.

A major adverse effect to monitor is muscle damage (myopathy, and in some cases rhabdomyolysis) and potential liver injury, shown by rising liver enzymes. Patients may report muscle aches or weakness, and severe cases can involve dark urine or other signs of liver stress, so liver function tests are often checked during therapy.

Other lipid-lowering drug classes work differently, which is why those options aren’t correct. Inhibiting cholesterol absorption in the intestine describes a drug that reduces gut absorption (not how statins work) and can be associated with constipation. Drugs that activate PPAR-alpha to decrease triglycerides are fibrates and have a different risk profile, including pancreatitis in some scenarios and potential muscle effects when used with statins. Drugs that increase cholesterol excretion via bile are bile acid sequestrants and have distinct GI effects and nutrient absorption considerations.