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49 Cards in this Set
- Front
- Back
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Maurice is a 58 year-old male with dyslipidemia and prostate enlargement. His only medication is tamsulosin 0.4 mg daily. He states that he cannot tolerate pravastatin due to muscle aches and joint pain. His cholesterol panel has the following values: Total CH 188 mg/dL, HDL 36 mg/dL, and TG 338 mg/dL. Calculate the patient's LDL cholesterol: Answer A64 mg/dL B84 mg/dL C104 mg/dL D114 mg/dL E125 mg/dL
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B84 mg/dL |
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A patient with hyperuricemia without a history of gout is going to start niacin therapy. Which of the following statements are correct? Answer ANiacin is contraindicated in gout, even if controlled with a uric acid lowering agent. BNiacin does not have an effect on uric acid. CNiacin will decrease the risk of the patient developing gout. DNiacin blocks xanthine oxidase. ENiacin should be used with caution if a patient has gout.
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ENiacin should be used with caution if a patient has gout. |
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Select the correct mechanisms of action of the statins. (Select ALL that apply.) Answer AStatins inhibit the enzyme HMG-CoA reductase. BStatins block the rate-limiting step in cholesterol synthesis. CStatins reduce cholesterol absorption at the brush-border. DStatins are peroxisome proliferator alpha activators. EStatins bind to and inhibit microsomal triglyceride transfer protein (MTP) in the endoplasmic reticulum. |
AStatins inhibit the enzyme HMG-CoA reductase. BStatins block the rate-limiting step in cholesterol synthesis. |
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How often should the Global Risk Assessment tool be done if a patient is classified as low risk? Answer AYearly BSemi-annually CEvery 3 years DEvery 4-6 years EEvery 10 years
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DEvery 4-6 years |
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A patient gave the pharmacist a prescription for Mevacor 40 mg PO nightly with dinner. Which of the following is an appropriate generic substitution for Mevacor? Answer AAtorvastatin BLovastatin CPravastatin DSimvastatin ERosuvastatin |
BLovastatin |
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What are the individual medicines included in the combination drug Vytorin? Answer AAtorvastatin + Niacin BAtorvastatin + Ezetimibe CLovastatin + Niacin DSimvastatin + Ezetimibe ESimvastatin + Niacin
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DSimvastatin + Ezetimibe |
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Which fibrate has an indication for use with a statin? Answer ATrilipix BTricor CLofibra DLipofen EFibricor |
ATrilipix |
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A pharmacist instructs a patient to contact the doctor right away if they are passing brown or dark-colored urine, feel more tired than usual or if their skin and/or whites of the eyes become yellow. Which of the following drugs is the most likely to need this counseling? Answer AQuestran BZetia CAdvicor DLovaza EMetamucil
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CAdvicor |
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Which of the following statins should be taken with the evening meal? Answer AAtorvastatin BLovastatin immediate-release CPravastatin DSimvastatin ELovastatin extended-release |
BLovastatin immediate-release |
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A patient with atrial fibrillation is currently taking aspirin, metoprolol, digoxin and verapamil. The physician wants to start the patient on lovastatin. Which of the following statements is correct regarding lovastatin in this patient? Answer AThe maximum dose of lovastatin is 20 mg daily due to the drug interaction with verapamil. BThe maximum dose of lovastatin is 40 mg daily due to the drug interaction with verapamil. CThe maximum dose of lovastatin is 20 mg daily due to the drug interaction with digoxin. DThe maximum dose of lovastatin is 40 mg daily due to the drug interaction with digoxin. ELovastatin is contraindicated in patients with atrial fibrillation.
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AThe maximum dose of lovastatin is 20 mg daily due to the drug interaction with verapamil. |
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What effects do statins have on cholesterol values? (Select ALL that apply.) Answer ARaises HDL BLowers HDL CRaises triglycerides DLowers LDL ELowers triglycerides
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ARaises HDL
DLowers LDL ELowers triglycerides |
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Which fibrate is given twice daily? Answer ATrilipix BTricor CLofibra DAntara ELopid |
ELopid |
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Nancy, a 64 year old female, has diabetes, heart failure and hyperlipidemia. She has been using atorvastatin 40 mg daily for the past four months. She is adherent with therapy. Her LDL was taken today and reported to be 124 mg/dL. Nancy's physician determines her LDL goal should be <100 mg/dL. Her physician wishes to double the atorvastatin dose; he states this will help Nancy reach her LDL goal. Choose the correct statement. Answer ADoubling the atorvastatin dose will likely lower the LDL to below 100 mg/dL. BThe patient may be able to reach the correct LDL goal if she switches to pitavastatin. CHer LDL goal should be less than 130 mg/dL; therefore, she is at goal. DAtorvastatin is contraindicated in patients with heart failure. EAccording to the ACC/AHA ATP-4 guidelines, treating to specific LDL targets is no longer recommended. |
EAccording to the ACC/AHA ATP-4 guidelines, treating to specific LDL targets is no longer recommended. |
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A patient comes to the pharmacy with a prescription for Niaspan. Which is the best way to counsel the patient regarding administration? Answer ATake this medication in the morning, at breakfast. BTake this medication at dinner. CTake with medication on an empty stomach. DTake this medication at bedtime, after a low fat snack. ETake this medication after a low fat snack. |
DTake this medication at bedtime, after a low fat snack. |
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What precentage on the 10-year ASCVD risk assessment score is used as the cut point to start statin therapy? Answer A≥ 2.5% B≥ 5% C≥ 7.5% D≥ 10% E≥ 15% |
C≥ 7.5% |
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A prescriber ordered TriCor 145 mg daily for his patient. The pharmacy did not have this exact strength, but did haveLofibra 134 mg. Can the pharmacist substitute Lofibra for the Tricor? Answer ANo, they are not interchangeable. BYes, if the pharmacist does not have anything better. CYes, because the doses are similar. DYes, because Lofibra 134 mg is bioequivalent to TriCor 145 mg. EYes, because he checked the Red Book.
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ANo, they are not interchangeable |
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Which of the following products are statin-niacin combinations? (Select ALL that apply.) Answer AAdvicor BSimcor CJuvisync DLiptruzet EVytorin |
AAdvicor BSimcor |
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A patient is going to start niacin therapy. Which of the following are side effects of niacin? (Select ALL that apply.) Answer ARenal impairment BIncrease in blood sugar CIncrease in blood pressure DIncrease in uric acid EFlushing
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BIncrease in blood sugar
DIncrease in uric acid EFlushing |
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Which of the following parameters are assessed on the Global Risk Assessment tool? (Select ALL that apply.) Answer AAge BLDL level CTotal cholesterol DHDL EGender |
AAge
CTotal cholesterol DHDL EGender |
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Which of the following statin regimens are considered high-intensity statin therapy? (Select ALL that apply.) Answer ACrestor 40 mg daily BLipitor 20 mg daily CCrestor 10 mg daily DLipitor 40 mg daily EZocor 40 mg daily |
ACrestor 40 mg daily
DLipitor 40 mg daily |
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A patient's triglycerides were recorded at 282 mg/dL. In which of the following conditions are the fenofibrate agents contraindicated? (Select ALL that apply.) Answer AHeart failure BGout CGallbladder disease DPregnancy ESevere liver disease
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CGallbladder disease
ESevere liver disease |
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Lovaza should be dispensed with caution to a patient with this allergy: Answer AFish or shellfish BDairy CSulfa DSoy or peanuts EFenofibrate medications
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AFish or shellfish |
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Jerry is a 70 year-old patient who was started on immediate-release niacin therapy. He is taking his medicine with food, and using an aspirin prior to the evening dose, but still gets hot, flushed and itchy. He asks if there is any form of niacin which would cause less flushing and itching. Which of the following niacin formulations have less flushing and itching? (Select ALL that apply.) Answer ARed Yeast Rice BSlo-Niacin CNiacor DNicotine ENiaspan |
BSlo-Niacin
ENiaspan |
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Which of the following cholesterol-lowering drug classes require liver enzyme monitoring at baseline due to a risk of hepatotoxicity? (Select ALL that apply.) Answer AFish oils BNiacins CFenofibrates DStatins EBile Acid Sequestrants
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BNiacins CFenofibrates DStatins |
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Possible side effects of Lovaza include: (Select ALL that apply.) Answer ABurping BArthralgias CDyspepsia DTaste perversions EFlatulence |
ABurping
CDyspepsia DTaste perversions |
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Which formulation of niacin has the highest risk for liver damage? Answer ANiaspan BSlo-Niacin CNiacor DInositol hexanicotinate EInositol hexaniacinate
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BSlo-Niacin |
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Select the correct mechanism of action of Welchol: Answer AIt reduces cholesterol absorption at the brush-border. BIt is a peroxisome proliferator alpha activator. CIt increases HDL synthesis. DIt inhibits the enzyme HMG-CoA reductase. EIt binds to bile acids in the gut. |
EIt binds to bile acids in the gut. |
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Maurice is a 58 year-old male with dyslipidemia and prostate enlargement. He was started on and is currently taking pravastatin 40 mg daily and tamsulosin 0.4 mg daily. Today he reports with muscle aches. The physician discontinued the pravastatin and evaluated Maurice for other conditions that can increase muscle damage and found none. According to the ACC/AHA ATP-4 guidelines, what would be an appropriate next step for treating Maurice's dyslipidemia? Answer AIf muscle aches resolve, restart pravastatin at 20 mg daily. BIf muscle aches do not resolve, restart pravastatin at 20 mg daily. CIf muscle aches resolve, start rosuvastatin at 20 mg daily. DIf muscle aches do not resolve, start rosuvastatin at 20 mg daily. EIf muscle aches resolve, do not use statin therapy again. |
AIf muscle aches resolve, restart pravastatin at 20 mg daily. |
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A patient's triglycerides were recorded at 510 mg/dL. Which of the following agents will help to lower triglycerides? (SelectALL that apply.) Answer ALovaza BTrilipix CNiacin DVascepa EWelChol |
ALovaza BTrilipix CNiacin DVascepa |
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Which of the following patient types would benefit from high-intensity statin therapy according to the ACC/AHA ATP-4 guidelines? (Select ALL that apply.) Answer AA 60 year old patient who is S/P MI BA 35 year old with a LDL of 140 mg/dL and no other comorbidies CA 80 year old patient who is S/P MI DA 45 year old patient with diabetes and a LDL of 140 mg/dL and no other comorbidities; 10-year ASCVD risk score is 6.5% EA 32 year old with a LDL of 195 mg/dL and no other comorbidites |
AA 60 year old patient who is S/P MI
EA 32 year old with a LDL of 195 mg/dL and no other comorbidites |
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A patient with chronic angina is currently taking aspirin, diltiazem, metoprolol and ranolazine. The physician wants to start the patient on simvastatin. Which of the following statements is correct regarding simvastatin in this patient? Answer AThe maximum dose of simvastatin is 10 mg daily due to the drug interaction with ranolazine. BThe maximum dose of simvastatin is 40 mg daily due to the drug interaction with ranolazine. CThe maximum dose of simvastatin is 10 mg daily due to the drug interaction with diltiazem. DThe maximum dose of simvastatin is 20 mg daily due to the drug interaction with diltiazem. ESimvastatin is contraindicated in patients with chronic angina. |
CThe maximum dose of simvastatin is 10 mg daily due to the drug interaction with diltiazem |
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A patient begins Niaspan and finds she suffers from red, itchy skin. She does not believe she can tolerate the medicine. Which of the following statements are correct that the pharmacist should provide to the patient? (Select ALL that apply.) Answer AIf your doctor permits it, take 325 mg of aspirin 30 minutes before the Niaspan; this should help reduce the problem. BTake Benadryl to reduce the problem since this is due to a histamine response. CAvoid alcohol, hot beverages and spicy food near the time of the medicine. DThis problem should lessen as you take the medicine continuously. ETake the Niaspan at bedtime; most of the problem will occur while you sleep. |
AIf your doctor permits it, take 325 mg of aspirin 30 minutes before the Niaspan; this should help reduce the problem.
CAvoid alcohol, hot beverages and spicy food near the time of the medicine. DThis problem should lessen as you take the medicine continuously. ETake the Niaspan at bedtime; most of the problem will occur while you sleep. |
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Which of the following formulations of niacin have less flushing and itching and does not have a heightened risk of hepatotoxicity? Answer ANiaspan BSlo-Niacin CNiacor DAdvicor ESimcor |
ANiaspan |
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Maria has been given a prescription for simvastatin 20 mg PO QHS. Which of the following statements are correct? (SelectALL that apply.) Answer AMary can take this medication in the morning if it works better for her schedule. BSimvastatin can cause pancreatitis; triglycerides should be monitored. CThe brand name of simvastatin is Zocor. DThe dose of simvastatin should be titrated to a max dose of 40 mg/day. EShe needs to take her simvastatin with food. |
CThe brand name of simvastatin is Zocor. DThe dose of simvastatin should be titrated to a max dose of 40 mg/day. |
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Which of the following medications should be avoided with simvastatin? (Select ALL that apply.) Answer ALopid BVFEND CTheo-24 DPlavix EBiaxin |
ALopid BVFEND
EBiaxin |
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A patient was prescribed atorvastatin 20 mg daily and returns to the clinic after having blood tests performed. His transaminases are elevated two times above the upper limit of normal (ULN). His primary care physician asks at what level should his statin therapy be discontinued due to elevated hepatic transaminase levels? Answer A2 times ULN; discontinue therapy now B3 times ULN C4 times ULN D5 times ULN E10 times ULN |
B3 times ULN |
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What is the indication for Lovaza? Answer ATo lower LDL cholesterol in patients with an LDL cholesterol ≥ 200 mg/dL. BTo lower triglycerides in patients with TGs ≥ 500 mg/dL as an adjunct to diet. CTo increase HDL in patients with familial-induced low HDL levels. DTo reduce the risk of statin-induced muscle damage. ETo lower triglycerides in patients with TGs ≥ 400 mg/dL as an adjunct to diet. |
BTo lower triglycerides in patients with TGs ≥ 500 mg/dL as an adjunct to diet. |
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Which groups would find benefit from statin therapy according to the ACC/AHA ATP-4 guidelines? (Select ALL that apply.) Answer APatients who have a coronary stent placed 4 years ago BPatients who have a LDL value ≥ 160 mg/dL CA 45 year old patient with diabetes and a LDL of 95 mg/dL DA 25 year old patient with diabetes and a LDL of 101 mg/dL EA 55 year old patient with an estimated 10 year ASCVD risk of 6% |
APatients who have a coronary stent placed 4 years ago
CA 45 year old patient with diabetes and a LDL of 95 mg/dL |
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Which of the following drugs could raise lipoprotein levels? (Select ALL that apply.) Answer AMontelukast BCyclosporine CAmiodarone DPrednisone EBeta-blockers |
BCyclosporine CAmiodarone DPrednisone EBeta-blockers |
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Which of the following patient types would benefit from moderate-intensity statin therapy according to the ACC/AHA ATP-4 guidelines? (Select ALL that apply.) Answer AThose unable to tolerate high-intensity statin therapy BA 35 year old with a LDL of 140 mg/dL and no other comorbidities CA 80 year old patient who is S/P MI DA 45 year old patient with diabetes and a LDL of 140 mg/dL and no other comorbidities; 10-year ASCVD risk score is 6.5% EA 32 year old with a LDL of 195 mg/dL and no other comorbidities |
AThose unable to tolerate high-intensity statin therapy
CA 80 year old patient who is S/P MI DA 45 year old patient with diabetes and a LDL of 140 mg/dL and no other comorbidities; 10-year ASCVD risk score is 6.5% |
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Which of the following cholesterol-lowering agents can increase bleeding risk and should be used cautiously in at-risk patients? Answer AQuestran BVascepa CLipitor DTricor ETrilipix
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BVascepa |
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Which of the following statements regarding Lovaza are true? (Select ALL that apply.) Answer ALovaza can be tried as an alternative to fenofibrates for lowering TGs. BLovaza must be used in addition to a low-fat diet. CIf the patient uses OTC fish oils, they may need to double the amount of capsules to get similar TG lowering. DLovaza does not increase LDL levels. EThe max dose of Lovaza is 2 capsules per day.
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ALovaza can be tried as an alternative to fenofibrates for lowering TGs. BLovaza must be used in addition to a low-fat diet. CIf the patient uses OTC fish oils, they may need to double the amount of capsules to get similar TG lowering. |
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In addition to an approval for lowering cholesterol when statins alone are not enough or when statins cannot be tolerated,Welchol has an additional indication for the following condition: Answer ATo reduce pain in rheumatoid arthritis. BTo help lower postprandial blood glucose in diabetes. CTo reduce uric acid in gout. DTo decrease cardiac remodeling in heart failure. ETo decrease symptoms associated with Crohn's disease or ulcerative colitis.
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BTo help lower postprandial blood glucose in diabetes. |
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A patient gave the pharmacist a prescription for Crestor 10 mg PO daily. Which of the following is an appropriate generic substitution for Crestor? Answer AAtorvastatin BLovastatin CPravastatin DSimvastatin ERosuvastatin |
ERosuvastatin |
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Which of the following statements are correct concerning bile acid sequestrants? (Select ALL that apply.) Answer ASipping or holding the cholestyramine suspension in the mouth can lead to tooth decay. BThese agents can lower TGs significantly. CThese agents can cause diarrhea. DThe patient should be told to take a multivitamin at a separate time due to a possible risk of decreased A, D, E and K absorption. EColesevelam is only available as tablets. |
ASipping or holding the cholestyramine suspension in the mouth can lead to tooth decay.
DThe patient should be told to take a multivitamin at a separate time due to a possible risk of decreased A, D, E and K absorption. |
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A patient gave the pharmacist a prescription for Pravachol 40 mg PO daily. Which of the following is an appropriate generic substitution for Pravachol? Answer AAtorvastatin BLovastatin CPravastatin DPitavastatin ERosuvastatin
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CPravastatin |
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A patient gave the pharmacist a prescription for Lipitor 40 mg PO daily. Which of the following is an appropriate generic substitution for Lipitor? Answer AAtorvastatin BLovastatin CPravastatin DSimvastatin ERosuvastatin |
AAtorvastatin |
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Which of the following side effects are associated with statin use? (Select ALL that apply.) Answer ARisk of diabetes BMemory loss CAlopecia DMyopathy EGingival hyperplasia
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ARisk of diabetes BMemory loss
DMyopathy |
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A patient gave the pharmacist a prescription for Livalo 2 mg PO daily. Which of the following is the generic name forLivalo? Answer AFluvastatin BLovastatin CPravastatin DPitavastatin ERosuvastatin |
DPitavastatin |
