Question

Mr. Peters is a 45-year-old who was diagnosed with hyperlip-

idemia during a routine physical examination. After following
health care provider recommendations for a low fat diet and
an exercise program, it was determined that treatment of his
lipid levels would also require a prescription for a lipid-lowering
drug. His prescriber ordered rosuvastatin (Crestor) 10 mg
orally once a day. Mr. Peters returns to the prescriber's office
a month after starting the drug stating that he is experiencing
aches and pains in his legs.
1. What is the likely cause of Mr. Peters's discomforts?
2. What action do you anticipate from the prescriber and
why?
3. What are key components of a teaching plan for Mr.
Peters today?

Answer 1

1) The statin (rosuvastatin) is likely the cause of Mr. Peters’ symptoms.

2) Labs would be ordered to assess his liver function, check his creatinine kinase to assess muscle damage.

Review comorbidities, medications, and diet and exercise routine to ensure the benefits of statin therapy outweigh the drawbacks.

If he is to continue statin therapy, recommend exercise to be low intensity and avoid muscle fatigue, increased water intake if not contraindicated, discuss potential benefits of adding coenzyme Q10 and vitamin D supplements, and ensure he is taking the statin at bedtime so that patient is sleeping when the strongest side effects should be occurring.

If these changes are not sufficient to allow Mr. Peters to tolerate this statin, consider pausing statin therapy or changing him to an alternative statin.

3) Diet and exercise education is the most important for Mr. Peters, including decreasing simple carbohydrate intake and increasing intake of healthy fats, and maintaining an exercise routine that does not exceed moderate exertion and avoids muscle fatigue.

Education on when to take his medication, what symptoms to watch for including signs of rhabdomyolysis.

Ensuring that the patient understands when to take his medication and why.