"August" 2021 Tianjin Medical and Health Recruitment Announcement | Announcement Summary (Updated Daily)

With the changes in people's living habits and eating habits, many friends' blood lipids have appeared abnormal. The main manifestations are elevated triglycerides and cholesterol. Dyslipidemia is an important risk factor for atherosclerotic cardiovascular and cerebrovascular diseases. Therefore, effectively controlling dyslipidemia and preventing and treating atherosclerosis are important measures to reduce the occurrence of dangerous cardiovascular and cerebrovascular events. Among them, a large number of friends take statins because of elevated cholesterol.

Statins are hydroxymethylglutaryl coenzyme A reductase inhibitors. These drugs competitively inhibit the endogenous cholesterol synthesis rate-limiting enzyme reductase and block intracellular oxymevalonic acid. Metabolic pathways reduce intracellular cholesterol synthesis, thereby lowering serum cholesterol levels. From the beginning of clinical application to the present, it has gone through three generations, with a total of 7 types. Let’s learn about them one by one:

There are three first-generation statins, namely simvastatin and lovastatin. Statins and pravastatin.

Simvastatin: a fat-soluble statin. The metabolism time is relatively short, and the half-life is only three hours, so it needs to be taken orally before going to bed. Lovastatin: It is a fat-soluble statin with a relatively short half-life of about three hours. Since it is better absorbed when combined with food, it is recommended to take it within half an hour after dinner. Pravastatin: It is the only water-soluble statin among the first generation statins. The lipid-lowering effect is similar to that of other generation statins, and the effect is better when taken after meals. However, it has a greater impact on kidney function. If you have kidney dysfunction, try not to take pravastatin. Since pradestatin does not enter the cerebrospinal fluid barrier, it does not affect nervous system function; it has less impact on liver function than other statins; it has less impact on blood sugar and is suitable for diabetic patients; it is less likely to cause muscle pain than other statins Drug-like small.

There is only one second-generation statin: fluvastatin.

Fluvastatin: It is the first fully chemically synthesized statin. The half-life is about two hours, similar to that of first-generation statins. There was no difference in effectiveness when taken with dinner or before bed. Fluvastatin has little impact on renal function and is the first choice lipid-lowering drug for patients with abnormal renal function; it has a greater impact on liver function, and patients with abnormal liver function or long-term heavy drinking need to choose this type of drug with caution; it has little muscle toxicity and is If you experience muscle toxicity while taking other statin drugs, you can try taking fluvastatin.

There are three third-generation statin drugs: atorvastatin, rosuvastatin and pitavastatin.

The characteristics of the third generation statins are long-acting drugs, and the medication requirements are not so high. Atorvastatin: a long-acting lipid-lowering drug with a half-life of up to 15 hours. Moreover, the lipid-lowering effect is significantly greater than that of the previous two generations of drugs. Because its half-life is relatively long, it is easier to choose the time of taking it, and it does not need to be taken before going to bed; patients with abnormal renal function can choose this type of drug, and patients with abnormal liver function should use this type of drug with caution. Rosuvastatin: It is the only water-soluble drug among the third-generation statin drugs. Because rosuvastatin is a water-soluble drug, it does not pass through the blood-brain barrier and has little impact on neurological function. It is mainly metabolized by the kidneys and requires high renal function. People with abnormal renal function should be careful when taking this drug. It has little impact on liver function. Those with minor symptoms and abnormal liver function can choose to take this type of drug. Pitavastatin: It is the third-generation statin drug with the smallest half-life, with a half-life of 11 hours, so pitavastatin still needs to be taken orally with dinner. The biggest feature of pitavastatin is that it has almost no effect on blood sugar, so it is suitable for people with a higher risk of diabetes.

For disorders of blood lipid metabolism, measures such as diet control, lifestyle adjustment, and avoidance and correction of other cardiovascular risk factors must first be adopted; if blood lipid levels have not reached normal levels after non-drug intervention, treatment should be taken as early as possible Lipid-adjusting medicine. But it should also be noted that each person has his own genetic characteristics: a certain drug is effective for A and has few side effects, but it may be ineffective for B, and may even cause allergies or other toxic side effects. We should keep in mind the principle of "medicine is divided into three parts poison".

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