Statins pharmacology

The individual statins differ with respect to their pharmacological properties, but in general the clinical consequences of this are limited, but may occasionally... 

Several studies have investigated whether statins possess pharmacologic properties in addition to their LDL cholesterollowering effect that may confer additional benefits in IHD.24 These studies were prompted by evidence that patients with normal LDL cholesterol derived benefit from statins. Statins have been shown to modulate the following characteristics thought to stabilize atherosclerotic plaques and contribute to the cardiovascular risk reduction seen with these drugs ... 

New substances of this family are in development, and we cannot exclude the possibility that oriented modifications of the molecules of SERMs, statins, or prostaglandin inhibitors will be able to enhance their effect on the breast or bone, maintaining equivalent power in their genuine indication. Knowing that a perfect multitasking molecule is unlikely, we can expect to obtain the maximal benefit from a single pharmacological intervention with substances with relevant added positive effects. 

Nadanadva, S. etal. (2007) Mitochondrial impairment by PPAR agonists and statins identified via immunocaptured OXPHOS complex activities and respiration. Toxicology and Applied Pharmacology,... 

Although it is not exactly clear how much these agents can reduce the risk of a major cardiac event (e.g., infarction, stroke), these drugs will probably remain the first choice for people with certain hyper-lipidemias (e.g., increased triglycerides). These drugs are likewise advocated for mixed hyperlipidemias that are common in metabolic disorders such as type 2 diabetes mellitus (see Chapter 32).32,141 Certain fibrates can be used with other drugs, such as statins, to provide more comprehensive pharmacologic control of certain lipid disorders.30,147... 

Contrast-induced nephropathy has been defined as an increase in serum creatinine of at least 25% or an absolute increase in serum creatinine of at least 0.5 mg/dL within 48 to 72 hours of iodinated contrast administration and is associated with significant morbidity and mortality (75). Important risk factors include diabetes mellitus, chronic renal insufficiency, administration of large volumes of high osmolar contrast agents, and intravascular volume depletion. Numerous pharmacologic preventive measures have been studied, but consistent benefits have not been demonstrated. In a recent large retrospective study, preprocedural statin therapy was independently associated with a lower risk of contrast nephropathy and nephropathy requiring dialysis (76). 

DA, Roden DM, Ingram C, Kitchner T, McCarty CA, Rotter JI, Krauss RM, Crawford DC, Wilke RA (2013) Exome scanning reveals RYR1 as a determinant for statin myopathy risk. Annual meeting of the American Society for Clinical Pharmacology and Therapeutics... 

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