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Medical Forum / General / General / June 2005

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Muscle Sorness caused by Medications

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Jason - 02 Jun 2005 18:08 GMT
Certain blood pressure medications and cholesterol medications cause some
people to develop muscle weakness. I seen a recent post in a newsgroup
indicating that there is some sort of blood test that helps doctors to
determine whether or not certain patients will develop muscle problems as
a result taking certain medications. I realize that lots of people post
false information in newsgroups so I would like for a doctor or medical
expert to tell me whether or not there is such a blood test and the name
of the blood test. I am NOT a doctor or medical expert.

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outrider - 02 Jun 2005 19:18 GMT
There is no such test. Yet. There may never be, but if there is, it
won't be one test, but several. For example:

There is genetic testing to determine if you are a carrier of certain
muscular dystrophies. Several people who have statin injury months and
years after stopping statins are testing positive as previously masked
genetic carriers for muscular dystrophies and metabolic disorders
including glycogen storage disorders. It is suspected their statin use
triggered the disorder.

I'm not a doctor Jason. I'm just one of the statin injured, who by and
large know more about this than most doctors.

Zee

> Certain blood pressure medications and cholesterol medications cause some
> people to develop muscle weakness. I seen a recent post in a newsgroup
[quoted text clipped - 9 lines]
> We respect those subscribers that ask for advice or provide advice.
> We do NOT respect the subscribers that enjoy criticizing people.
Jason - 03 Jun 2005 01:15 GMT
> There is no such test. Yet. There may never be, but if there is, it
> won't be one test, but several. For example:
[quoted text clipped - 8 lines]
> I'm not a doctor Jason. I'm just one of the statin injured, who by and
> large know more about this than most doctors.

outrider,
Thanks for the information. Do you have Hyperkalemia?
I'll pray for you.  
Jason

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Emma Chase VanCott - 02 Jun 2005 22:41 GMT
: Certain blood pressure medications and cholesterol medications cause some
: people to develop muscle weakness. I seen a recent post in a newsgroup

Uh, that's muscle _destruction_. Weakness is an early sign.

I think you are writing about Rhabdomyelosis AKA Rhabdo.

Emma
:)
Emma Chase VanCott - 02 Jun 2005 22:43 GMT
: Certain blood pressure medications and cholesterol medications cause some
: people to develop muscle weakness. I seen a recent post in a newsgroup
[quoted text clipped - 4 lines]
: expert to tell me whether or not there is such a blood test and the name
: of the blood test. I am NOT a doctor or medical expert.

One would look at tests that indicate muscle breakdown is occuring.

No. There is no *predictive* test of statin drug side effects.

Emma
:)
REP - 03 Jun 2005 04:41 GMT
> : Certain blood pressure medications and cholesterol medications cause some
> : people to develop muscle weakness. I seen a recent post in a newsgroup
[quoted text clipped - 8 lines]
>
> No. There is no *predictive* test of statin drug side effects.

There are some things that may make the risk of rhabdomyelosis higher,
including but not limited to:

concurrent fibrate therapy
hypotension
nephrotic syndrome

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Jason - 03 Jun 2005 06:34 GMT
> > : Certain blood pressure medications and cholesterol medications cause some
> > : people to develop muscle weakness. I seen a recent post in a newsgroup
[quoted text clipped - 15 lines]
> hypotension
> nephrotic syndrome

REP,
Thanks. I downloaded a report from Medline Plus earlier today related to
Rhabdomyolysis. I appreciate your post and the posts of others on this
subject. I should add that the report indicated that two complications of
Rhab... are listed and they are
Acute tubular necrosis
Acute renal failure
I also found out from the report that statin medications can in some cases
be the cause of Rhad...

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REP - 03 Jun 2005 11:48 GMT
> > > : Certain blood pressure medications and cholesterol medications cause
> > > some
[quoted text clipped - 26 lines]
> Acute tubular necrosis
> Acute renal failure

Yes, those are two reasons rhabdomyolysis is best avoided, and why those
with pre-existing kidney disease processes can be at a higher risk of
it, especially if on fibrate therapy as well (many kidney diseases cause
elevation of triglyceride levels, which is usually treated with
fibrates).

Here are some more complications, taken from American Family Physician:

Early complications
Hyperkalemia
Hypocalcemia
Hepatic inflammation
Cardiac arrhythmia
Cardiac arrest

Late complications
Acute renal failure
Disseminated intravascular coagulation

Early or late complication
Compartment syndrome

Another complication of rhabdomyolysis is death.

> I also found out from the report that statin medications can in some cases
> be the cause of Rhad...

I should have clarified that statins taken with fibrates pose a higher
risk of rhabdomyelosis; I have no idea if bile acid resins or nicotinic
acid taken with fibrates increase this risk.

More from AFP (3/1/2002):
Medications and Toxic  Substances That Increase the Risk of
Rhabdomyolysis

Direct myotoxicity
HMG-CoA reductase inhibitors, especially in combination with
fibrate-derived lipid-lowering agents such as niacin  (nicotinic acid;
Nicolar)
Cyclosporine (Sandimmune)
Itraconazole (Sporanox)
Erythromycin
Colchicine
Zidovudine (Retrovir)
Corticosteroids

Indirect muscle damage
Alcohol
Central nervous system depressants
Cocaine
Amphetamine
Ecstasy (MDMA)
LSD
Neuromuscular blocking agents

Traumatic,  Heat-Related, Ischemic and Exertional Causes of
Rhabdomyolysis

Traumatic causes
Lightning strike
Immobilization
Extensive third-degree burn
Crush injury
Heat-related causes
Heatstroke
Malignant hyperthermia
Neuroleptic malignant syndrome
Ischemic causes
Ischemic limb injury
Exertional causes
Marathon running
Physical overexertion in untrained athletes
Pathologic muscle exertion
Heat dissipation impairment
Physical overexertion in persons with sickle cell  disease

Infectious,  Inflammatory, Metabolic and Endocrinologic Causes of
Rhabdomyolysis

Infectious causes
Viruses: influenza virus B, parainfluenza virus,  adenovirus,
coxsackievirus, echovirus, herpes simplex virus, cytomegalovirus,  
Epstein-Barr virus, human immunodeficiency virus
Bacteria: Streptococcus, Salmonella, Legionella,  Staphyloccus and
Listeria species
Inflammatory causes
Polymyositis
Dermatomyositis
Capillary leak syndrome
Snake bites (mostly in South America, Asia and Africa)
Metabolic and endocrinologic causes
Electrolyte imbalances: hyponatremia, hypernatremia,  hypokalemia,
hypophosphatemia, hypocalcemia
Hypothyroidism
Thyrotoxicosis
Diabetic ketoacidosis
Nonketotic hyperosmolar syndrome

Genetic Causes of Rhabdomyolysis

Lipid metabolism
Carnitine palmitoyltransferase deficiency
Carnitine deficiency
Short-chain and long-chain acyl-coenzyme A  dehydrogenase deficiency
Carbohydrate metabolism
Myophosphorylase deficiency (McArdle's disease)
Phosphorylase kinase deficiency
Phosphofructokinase deficiency
Phosphoglycerate mutase deficiency
Lactate dehydrogenase deficiency (characteristic  elevation of creatine
kinase level with normal lactate dehydrogenase level)
Purine metabolism
Myoadenylate deaminase deficiency
Duchenne's muscular dystrophy

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"Did Father shoot him? I will eat Grandfather for dinner."
- Helen Keller, on learning of the death of her grandfather

Jason - 03 Jun 2005 17:29 GMT
> > > > : Certain blood pressure medications and cholesterol medications cause
> > > > some
[quoted text clipped - 141 lines]
>  Myoadenylate deaminase deficiency
>  Duchenne's muscular dystrophy

REP,
Thanks for the information--your post had some info. that was not in the
report that I downloaded from MedlinePlus.  Thanks so much--are there any
alternative medications to control Chol. other than statin medications?
I'll post another message related to this issue.
thanks again,
Jason

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