Cardiac Surgery Complications
Medical Management Manual

Nik Nikam, MD, FACC

 

Name	% Change ↓ -↑↔	Dosage	Commetns
Statins  HMG-CoA reductase inhibitors  Type II & IIb
Cerivastatin (Baycol)	TC=00% ↓   LDL=00% ↓ HDL=00%↑ TRG= 00%↓	0.2 to 0.8 mg qd	Myalgia Monitor LFTs
Fluvastatin (Lescol)	TC=00% ↓   LDL=00% ↓ HDL=00%↑TRG= 00% ↓	20 to 80 mg qd	Myalgia Monitor LFTs
Atrovastatin (Lipitor)	TC=00% ↓   LDL=00% ↓ HDL=00%↑ TRG= 00%↓	10 to 80 mg qd	Myalgia Monitor LFTs
Lovastatin (Mevacor)	TC=00% ↓   LDL=00% ↓ HDL=00%↑ TRG= 00%↓	10 to 80 mg qd	Myalgia Monitor LFTs
Pravastatin (Pravchol)	TC=00% ↓   LDL=00% ↓ HDL=00%↑ TRG= 00%↓	10 to 40 mg qd	Myalgia Monitor LFTs
Simvastatin (Zocor)	TC=00% ↓   LDL=00% ↓ HDL=00%↑ TRG= 00%↓	10 to 80 mg qd	Myalgia Monitor LFTs
	TC=00% ↓   LDL=00% ↓ HDL=00%↑ TRG= 00%↓
	TC=00% ↓   LDL=00% ↓ HDL=00%↑ TRG= 00%↓
Bile Acid Sequestrants
Colestipol (Colestid)	TC=00% ↓   LDL=00% ↓ HDL=00%↑ TRG= 00%↓	5G to 30g in divided does mixed with water	Constipation. Vitamin A, D, K, or Folic acid difficiency
Cholestyramine (Questran)	TC=00% ↓   LDL=00% ↓ HDL=00%↑ TRG= 00%↓	2 to 4 packets or scoops mixed with liquids	Constipation. Vitamin A, D, K, or Folic acid difficiency
Triglyceride lowering agents   Type IV & V
Gemfibrozil (Lopid)	TC=00% ↓   LDL=00% ↓ HDL=00%↑ TRG= 00%↓	600 mg qd or bid	Cramps, gallbladder disease
Fenofibrate (Tricor)	TC=00% ↓   LDL=00% ↓ HDL=00%↑ TRG= 00%↓	67, 134, or 200 mg with meals	Monitor CBC, LFTs. Avoid combining with statins (myopathy)
Nicotinic acid derivatives       Type IIa and IIb
Niaspan	TC=00% ↓   LDL=00% ↓ HDL=00%↑ TRG= 00%↓	500 to 1000 mg qd	Flushing, Tachycardia. Rabdomyolysis when used with statins
Fiber, OTC, nutritional suppliments and others
Metamucil fiber	TC=00% ↓   LDL=00% ↓ HDL=00%↑ TRG= 00%↓	1 tablesppon once or twice daily	Distension, cramps .
Antioxidants		one tab twice dialy	Prevent oxidation of LDL
Red Wine		1 to 2 glasses per day	Rich in antioxidants
Dried raisins			Rich in antioxidants