A patient presents to the clinic with complaints of muscle aches, ...

[justinmsk]

A patient presents to the clinic with complaints of muscle aches, muscle pain, and weakness. Upon review of the individual's medications, the nurse notes that the patient is concurrently taking gemfibrozil (Lopid) and atorvastatin (Lipitor).
 
  The nurse should assess the patient for the development of:
  a. migraines.
  b. hypothyroidism.
  c. myopathy.
  d. heart failure.

Question 2

A patient taking gemfibrozil (Lopid) and rosuvastatin (Crestor) concurrently begins to complain of muscle aches, fatigue, and weakness. What should the nurse monitor?
 
  a. For tendon tenderness
  b. For a lupuslike syndrome
  c. The patient's LFT results
  d. The patient's creatinine kinase levels

[SeanoH09]

Answer to Question 1

ANS: C
When gemfibrozil and a statin are taken concurrently, the risk of myopathy is increased more than with either agent alone. Migraines, hypothyroidism, and heart failure are not drug-to-drug interactions.

Answer to Question 2

ANS: D
Creatinine kinase levels are the best laboratory indicator of myopathy and/or rhabdomyolysis, which may lead to renal failure. As can the statins, gemfibrozil and other fibrates can cause myopathy. Fibrates must be used with caution in patients taking statins. Concurrent use of gemfibrozil and rosuvastatin does not cause tendon tenderness or a lupuslike syndrome. Liver function levels should be determined at the start of statin therapy and every 6 months thereafter in patients who do not have liver disease.

[justinmsk]

Excellent

[mohan]

TYSM