Drug Classification: Myocardial infraction

Indications

• Treatment of hypercholesterolaemia or mixed dyslipidaemia
• Reduction of cardiovascular morbidity and mortality in patients with a risk
• Management of peripheral vascular diseases

Mechanism of Action

Statins are 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors. HMG-CoA reductase is the rate-determining enzyme in cholesterol synthesis. Reduced intracellular cholesterol concentrations activate a cellular signaling cascade that results in the up-regulation of the gene coding for synthesis of LDL receptors. Increased LDL receptors (mainly in hepatocytes) cause increased LDL uptake into cells, resulting in lower plasma LDL levels. Simvastatin is an inactive pro-drug which is metabolized to its active form in the liver.

Lecture and CAL materials:

• Lecture: Lipoproteins, Cardiovascular Disease, and Drugs used to Treat Hyper-Lipidaemias
• YouTube video by ClinicalRPh.com: How Drugs Make Sense: HMG-CoA Reductase Inhibitors
• Medscape article by A Pollak and C Kramer: Pleiotropic Effects of Statins