A 60-year-old man with hypertension and type II diabetes comes in for a follow-up visit. Along with making appropriate diet and lifestyle changes, he is taking an ACE inhibitor-thiazide diuretic combination for his hypertension and metformin for his diabetes. His blood pressure and diabetes are under acceptable control. Routine blood work revealed normal electrolytes, renal function, and liver enzymes. He is noted to have elevated total cholesterol and low-density lipoprotein (LDL) levels, which have remained high in spite of his lifestyle changes. In an effort to reduce his risk of developing coronary artery disease, you start him on a 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor.
1) What is the mechanism of action of HMG-CoA reductase inhibitors?
2) What effect do they have on total and LDL cholesterol levels?
3) What are the common adverse effects of HMG-CoA reductase inhibitors?