Statins Mechanism Of Action *Animated*

STATINS ARE A GROUP OF MEDICATIONS THAT REDUCE CHOLESTEROL LEVELS, THEY WERE DISCOVERED BY AKIRA ENDO IN 1971 A JAPANESE BIOCHEMIST.
THERE ARE SEVERAL STATINS IN THE MARKET CURRENTLY WHICH ARE EASY TO REMEMBER BECAUSE THEY ALL END WITH THE SUFFIX STATIN.

CHOLESTEROL IS PRODUCED BY THE LIVER AND TRANSPORTED BY LIPOPROTEINS WHICH CONSIST OF TWO TYPES, LOW DENSITY LIPOPROTEIN LDL WHICH IS KNOWN AS THE BAD FAT, IT'S MAIN FUNCTION IS TO TRANSPORT CHOLESTEROL THROUGHOUT THE BODY, THE OTHER TYPE IS HIGH DENSITY LIPOPROTEIN ALSO KNOWN AS GOOD FAT, THIS TYPE OF LIPOPROTEIN REMOVES EXCESS CHOLESTEROL AND CARRIES IT BACK TO THE LIVER FOR DEGRADATION.

HOW DOES IT WORK?
STATINS WORK BY COMPETITIVELY INHIBIT HMG COENZYME A REDUCTASE THIS ENZYME CATALYZES THE REDUCTION OF HMG COENZYME TO MEVALONATE. WHICH IS THE RATE LIMITING STEP IN HEPATIC CHOLESTEROL BIOSYNTHESIS, INHIBITION OF THIS ENZYME DECREASES CHOLESTEROL SYNTHESIS LEADING TO AN UPREGULATION IN LDL RECEPTORS IN THE LIVER, THIS INCREASES LDL UPTAKE BY THE HEPATOCYTS DECREASING THE AMOUNT OF LDL CHOLESTEROL IN THE BLOOD.

WHO SHOULD STATINS BE GIVEN FOR?
ACCORDING TO THE AMERICAN COLLEGE OF CARDIOLOGY, STATINS ARE GIVEN AS A PREVENTION OF CARDIOVASCULAR DISEASE IN PATIENTS WITH LDL CHOLESTEROL MORE THAN 190 MG/DL. ON AVERAGE STATINS CAN LOWER BLOOD LDL BY 70 MG/DL WHICH TRANSLATES INTO AN ESTIMATED 60% DECREASE IN THE NUMBER OF CARDIAC EVENTS LIKE HEART ATTACKS OR SUDDEN CARDIAC DEATHS.



CONTRAINDICATIONS OF STATINS,
BEING DRUGS THAT ARE METABOLISED AND EXCRETED BY THE LIVER, STATINS ARE
CONTRAINDICATED IN CASES OF CHRONIC LIVER DISEASE, OR ELEVATION OF SERUM TRANSAMINASES. STATINS ARE ALSO NOT GIVEN IN PREGNANCY OR LACTATION AS THEY IN CATEGORY X.

LIFESTYLE MODIFICATION IS STRONGLY ADVISED TO PATIENTS ON STATINS THESE MODIFICATIONS INCLUDE, LESS CALORIC INTAKE, LOW ANIMAL FAT DIET, AND PHYSICAL EXCERCISE.

MONITORING CREATINE KINASE IS IMPORTANT IN PATIENTS TAKING STATIN AS MYOPATHY IS ONE OF THE MOST COMMON AND DANGEROUS ADVERSE EFFECT OF THIS CLASS OF MEDICATIONS