Simvastatin Drug Study

In making a Drug Study, the following elements must be present: Generic Name and the
Brand name (not all brands, just the brand used by the patient), Action, Indication,
Pregnancy Category, Drug Classification, and Contraindication, Adverse Effect, Drug
interaction and Nursing Consideration/Intervention. Most clinical instructors preferred this
to be in a long bond paper in printed or handwritten with paper in landscape.

Simvastatin
Brand Name: Zocor
Pregnancy Category X
Drug classes: Antihyperlipidemic, HMG CoA inhibitor
Therapeutic actions
Inhibits HMG co-enzyme A, the enzyme that catalyzes the first step in the
cholesterol synthesis pathway, resulting in a decrease in serum cholesterol,
serum LDLs, and either an increase or no change in serum HDLs.
Indications
Adjunct to diet in the treatment of elevated total cholestrol and LDL
cholesterol with primary hypercholesterolemia (types IIa and IIb) in
those unresponsive to dietary restriction of saturated fat and
cholesterol and other nonpharmacologic measures
To reduce the risk of stroke, TIA, MI in patients with coronary heart
disease and hypercholesterolemia
Treatment of patients with isolated hypertriglyceridemia
Treatment of type III hyperlipoproteinemia
Contraindications
Contraindicated with allergy to simvastatin, fungal byproducts,
pregnancy, lactation.
Use cautiously with impaired hepatic and renal function, cataracts.

Adverse effects
Headache, asthenia, sleep disturbances, Flatulence, diarrhea, abdominal
pain, cramps, constipation, nausea, dyspepsia, heartburn, liver
failure, Sinusitis, pharyngitis, Rhabdomyolysis, acute renal
failure, arthralgia, myalgia
Drug Interactions:
Increased risk
of myopathy and rhabdomyolysis with amiodarone, verapamil; do not
exceed 20 mg simvastatin daily
Increased risk of myopathy and rhabdomyolysis with clarithromycin,
erythromycin, HIV protease
inhibitors, itraconazole, ketoconazole, nefazodone; avoid concomitant
use, or suspend therapy during treatment with clarithromycin,
erythromycin, itraconazole, and ketoconazole
Increased risk of myopathy and rhabdomyolysis with
cyclosporine, fibrates, niacin; monitor patient closely if use together
cant be avoided. Dont exceed 10 mg simvastatin daily
Digoxin levels may increase slightly; closely monitor
plasma digoxin levels at the start of simvastatin therapy
Increased risk for hepatotoxicity with hepatotoxic drugs; avoid
concurrent use
Simvastatin may slightly enhance the anticoagulant effect of warfarin;
monitor PT and INR at the start of therapy and during dose adjustment
Nursing considerations
Ensure that patient has tried a cholesterol-lowering diet regimen for
36 mo before beginning therapy.
Give in the evening; highest rates of cholesterol synthesis are
between midnight and 5 AM.
Advise patient that this drug cannot be taken during pregnancy;
advise the use of barrier contraceptives.
Arrange for regular follow-up during long-term therapy. Consider
reducing dose if cholesterol falls below target.