Assignment: Atorvastatin for the Treatment of Hypercholesterolemia

Assignment: Atorvastatin for the Treatment of Hypercholesterolemia

Assignment: Atorvastatin for the Treatment of Hypercholesterolemia


Discuss about the NURS12154 Pharmacology for Nursing Practice: Drug Protocol Development.

Sample Draft Solution:

Drug therapy protocol for administering atorvastatin for the treatment of hypercholesterolemia

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Clinical Indication for Use Hypercholesterolemia, reducing risk of atherosclerotic vascular disease. (Mclever et al., 2017)
Inclusion Criteria
Prevention of cardiovascular disease

Hyperlipidemia (Ferreira et al.,2017)


As an adjunct to diet in Fredrickson II and IIb and adults with Fredrickson (Bhatt et al., 2016)

Exclusion Criteria
Current medication with Cyclosporine, Tipranavir plus Ritonavir and Telaprevir Patients with HIV and Hepatitis C risk myopathy thus precaution required.

Pregnancy (Barrios., et al 2015)

Pharmacodynamics (Mechanism of Action)
Atorvastatin is a selective competitive inhibitor of HMG-CoA reductase. An enzyme that converts 3-hydroxy-3methylglutaryl-coenzyme A to mevalonate, which is a precursor to body sterols including cholesterol. Atorvastatin thus lowers blood plasma cholesterol by inhibition of the enzyme HMG -CoA reductase and cholesterol synthesis in the liver. Also increases the hepatic LDL receptors enhancing LDL catabolism and uptake.
Pharmacokinetics (ADME)

Atorvastatin is rapidly absorbed after oral administration. Within 1-2 hours maximum plasma concentration is reached. Food availability decreases rate and extent of drug absorption by 25% and 9 % respectively. Evening administration shows lower plasma concentration as compared to evening. LDL -C is however reduced regardless of time of administration.


Atorvastatin has a mean volume of distribution of 381 litres.

Approximately 98 % of atorvastatin is bound to plasm proteins with poor penetration of 0.25 into red blood cells. Atorvastatin is secreted in human milk.


Atorvastatin is metabolized in the liver to ortho and parahydroxylated derivatives and other beta oxidation products.


Atorvastatin and its metabolites are primarily eliminated in bile. (Patel  et al ., 2015 )

Drug Interactions
Clarithromycin -Atorvastatin AUC increased, thus in patients using clarithromycin, dosage should not exceed 20 mg.

Protease inhibitors -HIV protease inhibitors and hepatitis protease C inhibitor increase atorvastatin AUC thus the lowest dose should be use in such patients.

Itraconazole – AUC of atorvastatin increased with administration of 40 mg atorvastatin and 200mg Itraconazole

Cyclosporine -increases bioavailability of atorvastatin. Administration of both concomitantly should be avoided. (Patel  et al ., 2015 )

Dose, Route, Duration of Therapy


Oral administration 10 -80 mg daily

(Bays et al.,2015 )

Adverse Effects
 Common: Nasopharyngitis, Arthralgia, Diarrhea, Pain in extremities Urinary tract infection, Dyspepsia, Nausea, Musculoskeletal pain, Muscle spasms, Myalgia, Insomnia, Pharyngolaryngeal pain

Rare: Pyrexia, Hepatitis, Epistaxis, Blurred vision (Adams et al.,2015)

Response to Adverse Event (this is directed at the practitioner to respond to an adverse event occurring)
Stop the medication immediately.

Assess the extent of severity.

Conduct lab hepatic tests.


Critical discussion

In clinical decision-making process, nurses gather relevant information available and utilize the information gathered to appropriately evaluate prevailing patient conditions and thus make sound judgement. Clinical decision making is a pivotal skill required by all nurses (Morton et al.,2017), more often newly registered nurses or novices encounter challenges as they try to execute this responsibility. Clinical decision-making process plays a major role in the quality of nursing care provided by the nurses to the patients. The decision-making process entails application of sound decisions at each stage in the processes, which are diagnosis, planning, implementation of existing patient needs and prevailing health demands that require to be attended to (Goode et al.,2015).  For this essay requirements the assessment implementation processes will be elaborately discussed.

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