BIOMEDICINE – Statins
ACTION: Decreases LDL and VLDL, plasma triglyceride levels; increases HDL concentration.
INDICATIONS: Prevention of cardiovascular disease in high-risk pts. Reduces risk of stroke and heart attack in pts with type 2 diabetes. Adjunct to diet therapy in management of hyperlipidemias.
SIDE EFFECTS:
Common: Atorvastatin is generally well tolerated. Side effects are usually mild and transient.
Frequent (16%):Headache.
Occasional (5%–2%):Myalgia, rash, pruritus,allergy.
Rare (less than 2%–1%):Flatulence, dyspepsia, depression.
ADVERSE EFFECTS/TOXIC REACTIONS: Potential for cataracts, photosensitivity, myalgia, rhabdomyolysis
PRECAUTIONS:
Contraindications: Active hepatic disease, breastfeeding, pregnancy, unexplained elevated ALT results.
Cautions: Anticoagulant therapy; history of hepatic disease; substantial alcohol consumption; pts with prior stroke/TIA; concomitant use of potent CYP3A4 inhibitors; elderly (predisposed to myopathy).
INTERACTIONS:
DRUG: Strong CYP3A4 inhibitors (e.g., clarithromycin, protease inhibitors, itraconazole) may increase concentration, risk of rhabdomyolysis. Cyclosporine may increase concentration. Gemfibrozil, fibrates, niacin, colchicine may increase risk of myopathy, rhabdomyolysis. Strong CYP3A4 inducers (e.g., rifampin, efavirenz) may decrease concentration.
HERBAL: St. John’s wort may decrease level.
FOOD: Grapefruit may increase serum concentrations. Red yeast rice may increase serum levels (2.4 mg lovastatin per 600 mg rice).
LAB VALUES: May increase serum transaminase, creatinine kinase concentrations
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(Lipitor)
TCM – Chapter 7: Substances that Transform Phlegm
Enters: LV, HT, SP
Temperature: warm
Taste: acrid
Properties: drying
ACTION: dries invisible phlegm through its warm and acrid properties
INDICATIONS: Phlegm accumulation in the blood vessels
Tongue: pale or pink
Pulse: slippery
RATIONALE: The action principle utilizes the 5-element generating cycle, treating the mother (LV) to affect the child (HT), thereby blocking the production of cholesterol in the liver and preventing the formation of atherosclerotic plaques in the blood vessels. Warm properties may damage LV blood/yin, and pungent properties may damage sinews governed by LV and muscles governed by SP, resulting in myofascial pain that will manifest in patients with preexisting deficient heat due to LV Blood and Yin deficiency.
CAUTION: Deficient heat due to Liver Blood, Yin deficiency
NOTE: excessive use may damage Yin and Marrow
MODIFICATIONS:
To counteract the side effect of myofascial pain – add CoQ10, Bai Shao,
To prevent marrow damage – add Sheng Di Huang, Omega 3