Clinical conundrums involving statin drug-drug interactions.

Statins are the cornerstone of pharmacologic therapy for the prevention and treatment of atherosclerotic cardiovascular disease. While they are generally considered safe, statins can be affected by drug-drug interactions (DDIs) that increase their systemic exposure increasing the risk for statin-associated muscle symptoms. These interactions are primarily mediated through metabolizing enzymes such as cytochrome P450 isoenzymes and membrane-bound drug transporting proteins including P-glycoprotein and organic ion transporting polypeptide.

Trends in high-intensity statin use and low-density lipoprotein cholesterol control among patients enrolled in a clinical pharmacy cardiac risk service.

Background: Although high-intensity statin therapy (HIST) is recommended for most patients between 21 and 75 years of age with atherosclerotic cardiovascular disease (ASCVD), several recent analyses examining contemporary statin use trends have identified a clinical care gap in the utilization of HIST.

Objective: The objective of this study was to assess secular trends in lipid management for patients with ASCVD enrolled in a clinical pharmacy program within an integrated health care delivery system.

Methods: We performed serial cross-sectional studies over time, comprising 18,006 adults with both acute and chronic ASCVD, to assess trends in statin use and low-density lipoprotein cholesterol (LDL-C) levels from 2007 to 2016.

Recommendations for Managing Drug-Drug Interactions with Statins and HIV Medications.

The discovery of antiretroviral therapy (ART) for the treatment of human immunodeficiency virus (HIV) has enabled individuals to live longer. As a result, HIV is now often considered a chronic condition. However, as a result of the increase in longevity or the HIV treatment modalities themselves, individuals with HIV are at high risk for the development of atherosclerotic cardiovascular disease.

Clinical Pharmacist Patient-Safety Initiative to Reduce Against-Label Prescribing of Statins With Cyclosporine.

Background: Against-label prescribing of statins with interacting drugs, such as cyclosporine, represents an important patient safety concern.

Objective: To implement and evaluate the effectiveness of a clinical pharmacist patient-safety initiative to minimize against-label prescribing of statins with cyclosporine.

Methods: Kaiser Permanente Colorado clinical pharmacists identified patients receiving both cyclosporine and against-label statin through prescription claims data.

Pharmacist prescribing practices in a clinical pharmacy cardiac risk service.

Purpose: Prescribing practices within a clinical pharmacy cardiac risk service (CPCRS) and their impact on treatment outcomes in patients with atherosclerotic cardiovascular disease (ASCVD) are described.

Summary: National healthcare reforms have increased the population of insured patients and placed increased demands on physicians and other providers. Pharmacists are well trained and positioned to aid in patient care by providing expertise in medication management and patient safety that can result in pharmacotherapy optimization and cost savings.

Complementary and alternative therapies for the management of dyslipidemia.

Objective: To review the literature on select alternative therapies for the management of dyslipidemia.

Data Sources: Searches of MEDLINE and PubMed (1965-March 2006) were conducted using the key terms omega-3-fatty acids, policosanol, plant stanols and sterols, flaxseed, red yeast rice, guggulipid, garlic, fiber, almonds, and cholesterol and/or lipids.

Study Selection And Data Extraction: Meta-analyses, published in English and involving adults, that incorporated randomized, controlled trials on alternative therapies for dyslipidemia were reviewed.