Aashi
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A 65-year-old man comes to the clinic for a regular follow-up visit. He states that he feels well. He had a myocardial infarction 18 months ago. He currently takes aspirin, metoprolol, and atorvastatin 20 mg daily. The patient is a former cigarette smoker. He is normotensive, weighs 102 kg, and his height is 180 cm. He exercises four times a week and maintains a low-fat diet. He was able to lose only three pounds over the past five months. Prior to the infarction his lab tests showed: total cholesterol 240 mg/dL, LDL 153 mg/dL, HDL 25 mg/dL, and triglycerides 290 mg/dL. He was not on any diet or medications at that time. Currently, his labs after the start of medications are: total cholesterol 210 mg/dL, LDL 127 mg/dL, HDL 35 mg/dL, and triglycerides 250 mg/dL.
Which of the following is the most appropriate next step?
(A) Change atorvastatin to gemfibrozil
(B) Continue atorvastatin 20 mg daily
(C) Increase the dose of atorvastatin to 40 mg daily and check cholesterol profile in 4 to 8 weeks
(D) Change atorvastatin to fluvastatin
(E) Continue atorvastatin at the present dose and add cholestyramine
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| prathapdoctor
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increase the dose of atorvastatin and check levels after 4 to 8 wks.
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| robin082006
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Agree
this patient has history of MI--> LDL should be <100mg/dl
This patient responses to atorvastatin but not as expected--> increase dose.
Answer C
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| Aashi
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YEep its C
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