Drug: Zocor (Simvastatin)

Topics: Squamous cell carcinoma, Esophageal cancer, Statin Pages: 26 (5457 words) Published: April 20, 2014

Medication Article Analysis Assignment
Drug: Zocor (Simvastatin)

Medication Analysis Paper
Katelyn Powers
November 1, 2013

94.1 million prescriptions of Zocor (simvastatin) were prescribed in United States during the year 2010. It is a generic cholesterol-lowering statin drug (DeNoon, 2010). High cholesterol, heart disease, diabetes, and heart attacks are all problems that plague the US. The increasing obesity rate of the US does not help with these factors and may contribute to why this prescription was the second most prescribed drug in the year 2010. I believe that in time it may become the number one most prescribed drug.

Zocor is a “statin” drug, also known as an antihyperlipidemic/ HMG-CoA inhibiter. (Karch, 2013) When cholesterol levels get too high the problems mentioned earlier become more apparent. To lower the blood cholesterol statin drugs inhibit an enzyme called HMG- CoA reductase, which is the enzyme that controls the cholesterol production in the liver. With this, there is a decrease in serum cholesterol, serum LDLs, and either an increase or no change in serum HDLs. Before taking this drug patients should know the adverse effects of the drug, interactions, and other teaching points. Some adverse effects of the drug are: headache, flatulence, diarrhea, abdominal pain, cramps, constipation, and nausea. It has a drug food interaction with grapefruit juice, which can cause toxic effects and decreased metabolism of the drug. Taking Zocor in the evening, having periodic blood tests, and using barrier contraceptives so as to avoid pregnancy are helpful teaching points also needed to know before starting Zocor. (Karch, 2013)

The toxic effects caused by the combination of Zocor and grapefruit juice occurs with most statin drugs. “A 40-year-old woman taking the popular anti-cholesterol drug Zocor…had been on Zocor for more than two years and was apparently healthy until 10 days prior to being admitted to the hospital with lower-extremity weakness.” (Zipes, 2004) This “lower extremity weakness” was the beginning of rhabdomyolysis, the breakdown of muscle tissue and subsequent kidney damage caused by the release of myoglobin (contents of the muscle fibers) into the bloodstream. (Dugdale, 2011) In this article she had consumed one grapefruit daily for two weeks before her admission into the hospital. The grapefruit lead to excessively high levels of Zocor. Bergamottin, is the compound in grapefruit that interacts with cytochrome P-450 and P-glycoprotein in the body. These two enzymes are responsible for the break down of Zocor, as well as other drugs, and transporting the drug into the body. The bergamottin compound prevents the enzyme systems from breaking down, which causes the drug to accumulate in high amounts, thus causing rhabdomyolysis. (Moll, 2013) In the article it suggests that this reaction may or may not have caused her case of rhabdomyolysis “eating a grapefruit each morning may have triggered a serious side effect” when in fact there is research proving that it will cause and is the underlying reason for this reaction. Any consumption not just regular/daily consumption can cause this effect and therefore any consumption of this fruit should be avoided.

The next article I found talks about another effect of Zocor. “In the Barrett’s (esophageal) population the use of statins were independently associated with reduced incidence of adenocarincoma”. The therapeutic effect appears to be because of the inhibition of HMG-CoA reductase. It not only reduces cholesterol production but it also “inhibits the proliferation and induces apoptosis in both malignant EAC cell lines (OE33 and Flo-1) and non-malignant QhERT Barrett’s cells.” (Beales, Hensley, Loke, 2013) This experimental laboratory study shows the breakthrough frontier on cancer treat and the unknown other beneficial effects of drugs. In the future this drug may be the preventative cure for esophageal...

References: 1. Zipes, D. (2004). Grapefruit and Zocor Don 't Mix. Medical Update, 29(11), 4.
2. Karch, A. (2013). 2013 lippincott 's nursing drug guide. (pp. 1047-1049). Wolters Kluwer.
3. Dugdale, D. (2011, September 19). Rhabdomyolysis. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000473.htm
5. DeNoon, D. (2011, April 20). The 10 most prescribed drugs. Retrieved from http://www.webmd.com/news/20110420/the-10-most-prescribed-drugs
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