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qfever
But isn't statin associated with hepatotoxicity too? FA 2019 page 320
+4
srdgreen123
@qfever. I think thats why OP said that statins are not metabolized in the liver.
+1
imgdoc
statins are metabolized by the liver, and they do cause hepatotoxicity, PRAVASTATIN specifically does not cause hepatotoxicity, because pravastatin isnt metabolized in the liver.
+2
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yb_26
They are just asking about side effect of statins, not about treatment of hypothyroidism
+5
mjmejora
Hypothyroidism is just a red herring.
+
ususmle
statins cause both hepatotoxic and mypopathy so I want for hepatotoxic:( I thought usmle expects different stuff
+1
drzed
Statins don't cause 'toxic hepatitis' they just cause a mild asymptomatic rise in LFTs that is reversible with discontinuation of the drug. The more worrisome side effect is of course, myopathy
+2
tyrionwill
statins cause both liver injury and myopathy in a dose related, so kidney failure increases their dose, which leads both liver and muscle risk elevated;
Pravastatin is said less liver concerns but the myopathy, so choose myopathy when renal failure.
+1
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submitted by โsajaqua1(607)
Pravastatin is the only statin drug not metabolized by the P450 system in the liver. Because of this, pravastatin is also unique in that more of it is excreted by the kidneys than any other statin, In addition to hypothyroidism this patient has mild renal failure. This will impair excretion of pravastatin, leading to increased pravastatin and its metabolites, increasing its potential for causing myopathy.
B) Nephrolithiasis- while the patient is hypercalcemic, pravastatin does not increase the incidence of kidney stones. C) Pancreatitis- I do not know of any significant interactions between the pancreas and pravastatin. D) Toxic hepatitis- while statins can cause mildly elevated liver function test scores, they are generally not associated with hepatotoxicity. E) Type 2 Diabetes mellitus- I do not know of any effect that pravastatin has on diabetes or diabetes medications.