QuestionSBA
QuestionChoice
This should be measured if statin-associated myopathy or rhabdomyolysis is suspected. It is not part of routine monitoring while taking a statin
34336
b
Creatinine kinase
QuestionChoice
This has no role or relevance in the monitoring of patients taking statins
34337
c
Full blood count
QuestionChoice
It is recommended to measure renal function prior to starting atorvastatin but routine monitoring is not necessary
34339
e
Urea and electrolytes
QuestionChoice
It is recommended that lipids be measured prior to starting treatment and may be measured for the duration of taking atorvastatin, but not for assessing the adverse effects of this drug
34338
d
Lipid profile
QuestionChoice
It is recommended that liver function should be measured prior to starting treatment and at 3 months and 12 months afterwards as atorvastatin is known to be hepatotoxic
34335
a
Liver function tests
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2810
Atorvastatin side effects
Topic
9
Internal Medicine
6878
Case Presentation: A 46 year old woman attends a follow-up appointment at her GP. **PMH** hyperlipidaemia. **DH** atorvastatin 20mg PO OD, started three months ago. **FH** father died of heart attack at the age of 53. **SH** current smoker, 15-20 cigarettes a day but currently attending smoking cessation counselling.


**Investigations**

Q-risk score: 14%

Question: Select the most appropriate option to monitor for adverse effects of the atorvastatin at this stage.
a