Nokea
A 44 year old man with type 2 DM and hyperlipidemia is currently taking daily simvastatin 40 mg. His lipid profile repeated 12 weeks after treatment shows the following results: Total cholesterol 4.2 mmol/L, HDL-cholesterol 0.9 mmol/L, LDL-cholesterol 2.2 mmol/L, Triglyceride 2.4 mmol/L. Which lipid regulating drug should be MOST appropriately added?
Correct Answer: C
Rationale: Simvastatin's cut LDL to 2.2, but triglycerides linger at 2.4 above 1.7's ideal and HDL's low at 0.9. Fenofibrate slashes triglycerides, lifts HDL, a perfect next step for this type 2 mix. Colestyramine binds bile, not triglycerides; omega-3 helps less here; nicotinic acid's harsh; ezetimibe's LDL focus misses. Nurses see this combo statin plus fibrate as a chronic lipid tune-up, dodging heart risks tied to diabetes.