Fluvastatin is a member of the statin drug class, used to treat hypercholesterolemia and to prevent cardiovascular disease. It was patented in 1982 and approved for medical use in 1994. It is on the World Health Organizations List of Essential Medicines. Adverse effects
Adverse effects are comparable to other statins. Common are nausea, indigestion, insomnia and headache. Myalgia (muscle pain), and rarely rhabdomyolysis, characteristic side effects for statins, can also occur. Interactions
Contrary to lovastatin, simvastatin and atorvastatin, fluvastatin has no relevant interactions with drugs that inhibit the liver enzyme CYP3A4, and a generally lower potential for interactions than most other statins. Fluconazole, a potent inhibitor of CYP2C9, does increase fluvastatin levels. Pharmacology
Mechanism of action
Fluvastatin works by blocking the liver enzyme HMG-CoA reductase, which facilitates an important step in cholesterol synthesis. Pharmacodynamics
In a Cochrane systematic review the dose-related magnitudes of fluvastatin on blood lipids was determined. Over the dose range of 10 to 80 mg/day total cholesterol was reduced by 10.7% to 24.9%, LDL cholesterol by 15.2% to 34.9%, and triglycerides by 3% to 17.5%. Pharmacokinetics
The drug is quickly and almost completely (98%) absorbed from the gut. Food intake slows down absorption, but does not decrease it. Due to its first-pass effect, bioavailability is lower: about 24–30% according to different sources. Over 98% of the substance is bound to plasma proteins.Several cytochrome P450 enzymes (mainly CYP2C9, but also CYP3A4 and CYP2C8) are involved in the metabolism of fluvastatin, which makes is less liable to interactions than most other statins.
Borderline intellectual functioning, also called borderline mental retardation (in the ICD-8), is a categorization of intelligence wherein a person has below average cognitive ability (generally an IQ of 70–85), but the deficit is not as severe as intellectual disability (below 70). It is sometimes called below average IQ (BAIQ). This is technically a cognitive impairment; however, this group may not be sufficiently mentally disabled to be eligible for specialized services. Codes
The DSM-IV-TR code of borderline intellectual functioning is V62.89. DSM-5 diagnosis codes are V62.89 and R41.83. Learning skills
During school years, individuals with borderline intellectual functioning are often "slow learners". Although a large percentage of this group fails to complete high school and can often achieve only a low socioeconomic status, most adults in this group blend in with the rest of the population. Differential diagnosis
According to the DSM-5, differentiating borderline intellectual functioning and mild intellectual disability requires careful assessment of adaptive and intellectual functions and their variations, especially in the presence of co-morbid psychiatric disorders that may affect patient compliance with standardized test (for example, attention deficit hyperactivity disorder (ADHD) with severe impulsivity or schizophrenia). See also
IQ classification
Special education

References
Further reading
Gillberg, Christopher (1995). Clinical child neuropsychiatry. Cambridge: Cambridge University Press. pp. 47–48. ISBN 0-521-54335-5. Harris, James C. (2006). Intellectual disability : understanding its development, causes, classification, evaluation, and treatment. New York: Oxford University Press. ISBN 0-19-517885-8.