A 59-year-old man with coronary artery disease and hypertension (BP 145/92 mmHg, HR 68) starts high-intensity lipid-lowering therapy. Three months later, he reports proximal muscle soreness and fatigue. Laboratory testing reveals elevated creatine kinase (892 U/L) and normal renal function. He denies dark urine and takes metoprolol for cardiac protection. Which of the following best describes the primary mechanism of the most likely offending drug causing his myopathy?
- A)Binding of bile acids in the intestinal lumen
- B)Inhibition of intestinal cholesterol absorption
- C)Inhibition of lipoprotein lipase
- D)Inhibition of HMG CoA reductaseGABARITO
- E)Activation of PPAR alpha
Explicação
Statins inhibit HMG CoA reductase, the rate limiting enzyme in hepatic cholesterol synthesis. They upregulate LDL receptors and are first line for lowering LDL, but can cause hepatotoxicity and myopathy, especially at high doses or with interacting drugs. Ver explicação completa e trilha adaptativa →