Ms endocrine assignment 2

Servant leaders are open-minded, listen deeply, try to fully understand others and not being judgmental Question 3 On the other hand, Ms. Which of the following behaviors best describes this style?

Ms endocrine assignment 2

Negative interactions are more likely with other choices [44] Persons taking gemfibrozila non-statin Ms endocrine assignment 2 drug Atorvastatin Persons taking the anticoagulant warfarin Any statin The statin use may require that the warfarin dose be changed, as some statins increase the effect of warfarin.

Ms endocrine assignment 2

The risk of statin-induced rhabdomyolysis increases with older age, use of interacting medications such as fibratesand hypothyroidism. A common variation in this gene was found in to significantly increase the risk of myopathy.

However, the risk was over fold greater if cerivastatin was used, or if the standard statins atorvastatin, fluvastatin, lovastatin, pravastatin, or simvastatin were combined with a fibrate fenofibrate or gemfibrozil treatment. Cerivastatin was withdrawn by its manufacturer in Consumption of grapefruit or grapefruit juice inhibits the metabolism of certain statins.

Bitter oranges may have a similar effect. The absolute prohibition of grapefruit juice consumption for users of some statins is controversial. Protease inhibitors and statins taken together may increase the blood levels of statins and increase the risk for muscle injury myopathy.

The most serious form of myopathy, rhabdomyolysis, can damage the kidneys and lead to kidney failure, which can be fatal. Cholesterol homeostasis Statins act by competitively inhibiting HMG-CoA reductasethe rate-limiting enzyme of the mevalonate pathway.

Ms endocrine assignment 2

This competition reduces the rate by which HMG-CoA reductase is able to produce mevalonatethe next molecule in the cascade that eventually produces cholesterol.

A variety of natural statins are produced by Penicillium and Aspergillus fungi as secondary metabolites. These natural statins probably function to inhibit HMG-CoA reductase enzymes in bacteria and fungi that compete with the producer.

This is significant because most circulating cholesterol comes from internal manufacture rather than the diet. When the liver can no longer produce cholesterol, levels of cholesterol in the blood will fall. Cholesterol synthesis appears to occur mostly at night, [] so statins with short half-lives are usually taken at night to maximize their effect.

Studies have shown greater LDL and total cholesterol reductions in the short-acting simvastatin taken at night rather than the morning, [] [] but have shown no difference in the long-acting atorvastatin.

The sterol response elements then facilitate increased transcription of various other proteins, most notably, LDL receptor. The LDL receptor is transported to the liver cell membrane and binds to passing LDL and VLDL particles colloquially, "bad cholesterol"mediating their uptake into the liver, where the cholesterol is reprocessed into bile salts and other byproducts.

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This results in a net effect of less LDL circulating in blood. Decreasing of specific protein prenylation[ edit ] Statins, by inhibiting the HMG CoA reductase pathway, simultaneously inhibit the production of both cholesterol and specific prenylated proteins see diagram.

This inhibitory effect on protein prenylation may be involved, at least partially, in the improvement of endothelial function, modulation of immune function, and other pleiotropic cardiovascular benefits of statins, [] [] [] [] [] [] as well as in the fact that a number of other drugs that lower LDL have not shown the same cardiovascular risk benefits in studies as statins, [] and may also account for certain of the benefits seen in cancer reduction with statins.Flashcard Machine - create, study and share online flash cards My Flashcards; Flashcard Library; About; Contribute; Search; Help; Sign In; Create Account.

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