MEDICINEINWROLD Telegram 12383
๐ŸŒ ุงู„ุทุจ ููŠ ุฌู…ูŠุน ุฃู†ุญุงุก ุงู„ุนุงู„ู… ๐ŸŒ
๐Ÿ›‘ ุญุงุฌุฉ ุฅุณู…ู‡ุง ุงู„statins ุฃู…ุชู‡ ูˆุงุฒุงูŠ ู†ูƒุชุจู‡ุง ูˆูƒุฏู‡
ู†ุชูƒู„ู… ุนู† ุญุงุฌู‡ ูˆู‡ูŠ ุงู„statins ุฃู…ุชู‡ ูˆุงุฒุงูŠ ู†ูƒุชุจู‡ุง ูˆูƒุฏู‡
ุงูˆู„ุง statin ู‡ูŠ ุญุงุฌู‡ ุจุชู†ู‚ุต ุงู„LDL
ูˆุงู„lipid ุนู…ูˆู…ุง ููŠ ุงู„ุฌุณู… ูˆุฏูŠู‡ ุญุงุฌู‡ ู…ู‡ู…ู‡ ุนุดุงู† ู„ูˆ ุงู„ุฏู‡ูˆู† ุฒุงุฏุช ุจุชุนู…ู„ ู…ุดุงูƒู„ ุฒูŠ Atherosclerosis ูˆุจุชุฒูˆุฏ insulin resistance
ูˆู†ู‚ูŠู…ู‡ุง ู…ู† ุชุญู„ูŠู„ ุงุณู…ู‡ lipid profile

ุทูŠุจ ู†ูƒุชุจู‡ุง ุงู…ุชู‡ุŸ
ูˆู„ุงุฒู… ุชู…ุดูŠ ุจุงู„ุชุฑุชูŠุจ ุฏู‡..
๐Ÿ”นู„ูˆ ุนุงูˆุฒูŠู† ู†ุนู…ู„ secondary prevention ู„ู…ุฑุถ ู…ุซู„ุง ุฒูŠ ุญุฏ ุฌุงู„ู‡ stroke ูˆุนุงูˆุฒูŠู† ู†ู‚ู„ู„ ูุฑุตู‡ ุงู†ู‡ุง ุชุฌูŠู„ู‡ ุชุงู†ูŠ
ูˆููŠ 2ry prevention ุจู†ุฏูŠ
high intensity statin
ูˆู‡ู‚ูˆู„ ูŠุนู†ูŠ ุงูŠู‡ ูƒู…ุงู† ุดูˆูŠู‡.

๐Ÿ”น ู„ูˆ LDL ู…ุนุฏูŠ 190
ู‡ุชุฏูŠ high intensity statin
(normal LDL less than 100)..

๐Ÿ”น ุทูŠุจ ู…ูŠู† ู†ุนู…ู„ู‡ primary preventionุŸ ุŸ ุงูŠ ุญุฏ ูƒุฏู‡ ู…ุนุฏูŠ ูŠุงุฎุฏ statin ุŸ
ู„ุง
ู‡ู†ุง ุชุญุณุจ ุณูƒูˆุฑ ุงุณู…ู‡
ASCVD 10 year risk
(atherosclerotic cardiovascular disease " as mi ot stroke ")
ู…ูˆุฌูˆุฏ ุนู„ู‰ mdcalc app
ุจุชุฏุฎู„ ูƒุฐุง ุจูŠุงู† ูˆูŠุทู„ุนู„ูƒ ูุฑุตู‡ ุงู† ูŠุฌูŠู„ู‡ ุฌู„ุทู‡ ุฒูŠ ุงู„ู…ุฎ ูˆุงู„ู‚ู„ุจ ู ุฎู„ุงู„ 10 ุณู†ูŠู† ู‚ุฏ ุงูŠู‡ุŸ ู„ูˆ ู…ู†

*0 - 7.5% :low risk don't give statin unless diabetic type 2 hence give moderate intensity statin.

*7.5-20% : moderate risk give moderate intensity statin.

* >20%  :high risk give high intensity statin.

๐Ÿ’ฌูŠุนู†ูŠ ุงูŠู‡ intensity statins ุฏูŠู‡ุŸ

~Moderate intensity statin :

Atorvastatin (Atorยฎ ) :20-40 mg or
Rosuvastatin (epirovastin ยฎ) : 10 - 20 mg

~High intensity statin : Atorvastatin 40-80mg
or
Rosuvastatin : 20 - 40 mg

๐Ÿ’ฌุงู„rosuva ููŠ ุงู„ุนู…ูˆู… ุงู‚ูˆูŠ ู…ู† ator ุจุณ ุงู„ator ู†ูุถู„ู‡ ู ุนูŠุงู†ูŠู† ุงู„kidney ุนุดุงู† safe.

ุทูŠุจ.. ู‡ุฏูŠ statin ูˆุฃูุถู„ ุงุนู„ูŠ ู ุฌุฑุนู‡ ู„ุญุฏ ู…ุง ุงูˆุตู„ ุงู„target LDL
ุงู„ู„ูŠ ู‡ูˆ ูƒุงู…ุŸ ุงู‚ู„ ู…ู† 50
ูˆููŠู‡ ูŠู‚ู„ูƒ ูƒู„ ุงู…ุง ุชู‚ู„ู„ ุงุญุณู†

๐Ÿ’ฌ ุงูŠู‡ ุงู„side effects ุงู„ู…ุดู‡ูˆุฑู‡ ู„ูŠู‡ุŸ

- statin induced myalgia
-Arthralgia
-hepatic impairment
-Dizziness
-GIT upset

๐Ÿ’ฌ When to be contraindicated?
~Pregnancy
~Acute hepatic injury or rising alt ast
~CKD

~Intolerance to myalgia
ู„ูˆ ุญุตู„ ุฏู‡
start with low dose statin 10mg then up titration.. Or Combine with ezetimibe
ุฏูˆุง ุงุณู…ู‡ (atoreza 25/10ยฎ)
ุงูˆ cholerose plus

ุจุณ ูƒุฏู‡



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ู†ุชูƒู„ู… ุนู† ุญุงุฌู‡ ูˆู‡ูŠ ุงู„statins ุฃู…ุชู‡ ูˆุงุฒุงูŠ ู†ูƒุชุจู‡ุง ูˆูƒุฏู‡
ุงูˆู„ุง statin ู‡ูŠ ุญุงุฌู‡ ุจุชู†ู‚ุต ุงู„LDL
ูˆุงู„lipid ุนู…ูˆู…ุง ููŠ ุงู„ุฌุณู… ูˆุฏูŠู‡ ุญุงุฌู‡ ู…ู‡ู…ู‡ ุนุดุงู† ู„ูˆ ุงู„ุฏู‡ูˆู† ุฒุงุฏุช ุจุชุนู…ู„ ู…ุดุงูƒู„ ุฒูŠ Atherosclerosis ูˆุจุชุฒูˆุฏ insulin resistance
ูˆู†ู‚ูŠู…ู‡ุง ู…ู† ุชุญู„ูŠู„ ุงุณู…ู‡ lipid profile

ุทูŠุจ ู†ูƒุชุจู‡ุง ุงู…ุชู‡ุŸ
ูˆู„ุงุฒู… ุชู…ุดูŠ ุจุงู„ุชุฑุชูŠุจ ุฏู‡..
๐Ÿ”นู„ูˆ ุนุงูˆุฒูŠู† ู†ุนู…ู„ secondary prevention ู„ู…ุฑุถ ู…ุซู„ุง ุฒูŠ ุญุฏ ุฌุงู„ู‡ stroke ูˆุนุงูˆุฒูŠู† ู†ู‚ู„ู„ ูุฑุตู‡ ุงู†ู‡ุง ุชุฌูŠู„ู‡ ุชุงู†ูŠ
ูˆููŠ 2ry prevention ุจู†ุฏูŠ
high intensity statin
ูˆู‡ู‚ูˆู„ ูŠุนู†ูŠ ุงูŠู‡ ูƒู…ุงู† ุดูˆูŠู‡.

๐Ÿ”น ู„ูˆ LDL ู…ุนุฏูŠ 190
ู‡ุชุฏูŠ high intensity statin
(normal LDL less than 100)..

๐Ÿ”น ุทูŠุจ ู…ูŠู† ู†ุนู…ู„ู‡ primary preventionุŸ ุŸ ุงูŠ ุญุฏ ูƒุฏู‡ ู…ุนุฏูŠ ูŠุงุฎุฏ statin ุŸ
ู„ุง
ู‡ู†ุง ุชุญุณุจ ุณูƒูˆุฑ ุงุณู…ู‡
ASCVD 10 year risk
(atherosclerotic cardiovascular disease " as mi ot stroke ")
ู…ูˆุฌูˆุฏ ุนู„ู‰ mdcalc app
ุจุชุฏุฎู„ ูƒุฐุง ุจูŠุงู† ูˆูŠุทู„ุนู„ูƒ ูุฑุตู‡ ุงู† ูŠุฌูŠู„ู‡ ุฌู„ุทู‡ ุฒูŠ ุงู„ู…ุฎ ูˆุงู„ู‚ู„ุจ ู ุฎู„ุงู„ 10 ุณู†ูŠู† ู‚ุฏ ุงูŠู‡ุŸ ู„ูˆ ู…ู†

*0 - 7.5% :low risk don't give statin unless diabetic type 2 hence give moderate intensity statin.

*7.5-20% : moderate risk give moderate intensity statin.

* >20%  :high risk give high intensity statin.

๐Ÿ’ฌูŠุนู†ูŠ ุงูŠู‡ intensity statins ุฏูŠู‡ุŸ

~Moderate intensity statin :

Atorvastatin (Atorยฎ ) :20-40 mg or
Rosuvastatin (epirovastin ยฎ) : 10 - 20 mg

~High intensity statin : Atorvastatin 40-80mg
or
Rosuvastatin : 20 - 40 mg

๐Ÿ’ฌุงู„rosuva ููŠ ุงู„ุนู…ูˆู… ุงู‚ูˆูŠ ู…ู† ator ุจุณ ุงู„ator ู†ูุถู„ู‡ ู ุนูŠุงู†ูŠู† ุงู„kidney ุนุดุงู† safe.

ุทูŠุจ.. ู‡ุฏูŠ statin ูˆุฃูุถู„ ุงุนู„ูŠ ู ุฌุฑุนู‡ ู„ุญุฏ ู…ุง ุงูˆุตู„ ุงู„target LDL
ุงู„ู„ูŠ ู‡ูˆ ูƒุงู…ุŸ ุงู‚ู„ ู…ู† 50
ูˆููŠู‡ ูŠู‚ู„ูƒ ูƒู„ ุงู…ุง ุชู‚ู„ู„ ุงุญุณู†

๐Ÿ’ฌ ุงูŠู‡ ุงู„side effects ุงู„ู…ุดู‡ูˆุฑู‡ ู„ูŠู‡ุŸ

- statin induced myalgia
-Arthralgia
-hepatic impairment
-Dizziness
-GIT upset

๐Ÿ’ฌ When to be contraindicated?
~Pregnancy
~Acute hepatic injury or rising alt ast
~CKD

~Intolerance to myalgia
ู„ูˆ ุญุตู„ ุฏู‡
start with low dose statin 10mg then up titration.. Or Combine with ezetimibe
ุฏูˆุง ุงุณู…ู‡ (atoreza 25/10ยฎ)
ุงูˆ cholerose plus

ุจุณ ูƒุฏู‡

BY ๐ŸŒ ุงู„ุทุจ ููŠ ุฌู…ูŠุน ุฃู†ุญุงุก ุงู„ุนุงู„ู… ๐ŸŒ


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