rhabdomyolysis
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rhabdomyolysis in the news

FDA Approves New Label for VYTORIN(R) (ezetimibe/simvastatin) 

[Press Release] Business Wire via Yahoo! Finance - Oct 05 5:45 AM
WHITEHOUSE STATION, N.J. & KENILWORTH, N.J.----Merck/Schering-Plough Pharmaceuticals announced today that the U.S. Food and Drug Administration has approved the inclusion of new data in the product label that showed VYTORIN® was more effective than Crestor® at lowering LDL "bad" cholesterol at all doses compared, ranging from the usual recommended starting doses to the maximum approved doses .

Early Statin Therapy For Patients With Acute Coronary Syndromes Reduces Death, Cardiovascular Events 
Science Daily - Oct 01 6:00 AM
Early, intensive therapy with statin medications reduces death and cardiovascular events for patients who have had heart attacks or other acute heart events, according to an analysis of previous studies published in the September 25 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

POLICE OFFICER, ASPIRING WRESTLER STILL HOSPITALIZED A WEEK AFTER WWE CANADIAN TRYOUT 
PWinsider - Sep 28 12:09 PM
Today's edition of Canadian newspaper The Kingston Whig-Standard reported that Jason Maschke, a police officer and aspiring wrestler, was still hospitalized a week after a condition brought on by the physicality of his recent World Wrestling Entertainment tryout in Ottawa.

Pills & Ills: ; What's the Benefit of Coenzyme Q10? 
RedNova - Sep 18 11:07 PM
By Richard Harkness Q: Is there any research showing that CoQ10 can prevent the muscle problems caused by statin drugs? If so, what dosage should be taken? A: This topic gets lots of mail, so it's time for an update.

rhabdomyalysis

 

 

- definition of rhabdomyolysis

- rhabdomyolysis

Rhabdomyolysis
Classifications and external resources
ICD-10 M62.89, T79.6
ICD-9 728.88

Rhabdomyolysis is the breakdown rhabdomyalysis of skeletal muscle due to injury, either mechanical, physical or chemical. The principal result of rhabdomyolsis this process is acute renal failure due to rhabdomylysis accumulation of muscle breakdown products in the bloodstream, several of which are injurous to rhabdomolysis the kidney. Treatment is with intravenous fluids, and dialysis if necessary.

Contents

  • 1 Causes
  • 2 Pathophysiology
  • 3 Diagnosis
  • 4 Clinical rhabdomyolusis sequelae
  • 5 Therapy
  • 6 See rhabdomyelysis also
  • 7 References
  • 8 External links

Causes

The injury that leads to rhabdomyolysis can be due rhabdomyolisis to rhabdomyloysis mechanical, physical and chemical causes:

  • mechanical: crush trauma, excessive exertion, intractable convulsions, choreoathetosis, surgery, rhabodmyolysis compression by a tourniquet left for too long, local muscle compression due to comatose rabdomyolysis states, compartment syndrome, rigidity due to neuroleptic malignant syndrome
  • physical: high fever or hyperthermia, electric current
  • chemical: metabolic rrhabdomyolysis disorders, anoxia of the muscle (e.g. Bywaters' syndrome, toxin- and rhabomyolysis drug-related; various animal toxins, certain mushrooms like Tricholoma equestre, some antibiotics, statins, alcohol

Rhabdomyolysis can occur in acute hepatic porphyrias. Drug induced rhabdomyolysis should be rhabdomyolyis investigated for acute rhabdomyolysis hepatic porphyrias.

Drugs such as lovastatin, a hydroxymethylglutaryl-coenzyme A reductase inhibitor, have been associated with rhabdomyolysis. Drug-induced rhabdomyolysis appears to be definition of rhabdomyolysis increasing in incidence possibly due to rhabdomyolysis treatment the introduction of increasingly potent drugs into clinical practice. Any drug which directly or indirectly impairs the production exertional rhabdomyolysis or use of adenosine triphosphate (ATP) by skeletal muscle, what is rhabdomyolysis or increases energy requirements so as to exceed ATP production, lipitor rhabdomyolysis can cause rhabdomyolysis (Larbi 1998).

Pathophysiology

Severe cases of rhabdomyolysis often result in myoglobinuria, a condition where the myoglobin rhabdomyolysis bicarb drip from muscle breakdown spills into the urine, hepatitis c and rhabdomyolysis making it dark, or "tea colored" (myoglobin contains heme, like hemoglobin, giving muscle tissue its characteristic red color). This condition can cause serious keppra rhabdomyolysis kidney damage in severe cases. The injured muscle also rhabdomyolysis + rehab leaks potassium, leading to hyperkalemia, which may cause critical care rhabdomyolysis bicarb drip fatal disruptions in heart rhythm. In addition, myoglobin is metabolically degraded into potentially toxic substances for the kidneys. Massive skeletal muscle necrosis diagnosis of rhabdomyolysis may further aggravate the situation, by reducing plasma volumes pathophysiology rhabdomyolysis and leading to shock and reduced bloodflow to the kidneys.

Diagnosis

The diagnosis is typically made when an abnormal rhabdomyolysis heart renal function and elevated creatine kinase and potassium levels are observed in a patient. To distinguish the causes, a careful rhabdomyolysis lipitor medication history is considered useful. Testing for myoglobin levels in blood and urine is rarely performed due baycol rhabdomyolysis to its cost. Often the diagnosis is suspected when a rhabdomyolysis + lipitor urine dipstick test is positive for blood, but no cells are seen on microscopic rhabdomyolysis pravachol analysis. This suggests myoglobinuria, and rhabdomyolysis symptoms usually prompts a measurement of the serum creatine kinase, which confirms the diagnosis.

Clinical sequelae

  • Hypovolemia (sequestration of plasma water within which narcotics cause rhabdomyolysis injured myocytes)
  • Hyperkalemia (release of cellular potassium zocor rhabdomyolysis into circulation)
  • Metabolic acidosis (release of cellular phosphate and sulfate)
  • Acute renal failure (nephrotoxic effects of liberated acute exertional rhabdomyolysis myocyte components)
  • Disseminated intravascular coagulation (DIC)
  • Hypocalcemia (low calcium levels due to causes of rhabdomyolysis precipitation with phosphate), followed by hypercalcemia (as renal function recovers)

Therapy

The main elevated creatine in rhabdomyolysis therapeutic measure is hyperhydration (by administering intravenous fluids), and if necessary the use of diuretics (to prevent fluid pediatric rhabdomyolysis overload). Alkalinisation of the urine with bicarbonate reduces the amount rhabdo rhabdomyolysis of myoglobin accumulating in the kidney.

As the electrolytes are frequently deranged, these may require rhabdomyolysis and heat exhaustion correction, especially hyperkalemia (elevated potassium levels in the blood). Calcium levels are initially low (hypocalcemia), as circulating calcium precipitates in rhabdomyolysis and lipitor the damaged muscle tissue, presumably with phosphate released rhabdomyolysis and statin drugs from intracellular stores. When the acute renal failure resolves, vitamin D rhabdomyolysis case studies levels rise rapidly, causing hypercalcemia (elevated calcium). Although this resolves rhabdomyolysis lopid eventually, high calcium levels may require treatment with bisphosphonates (e.g. pamidronate).

See also

  • Cerivastatin

References

  • Cecil Textbook of Medicine
  • The Oxford Textbook of Medicine
  • Intensive Care Medicine by Irwin and Rippe
  • The ICU Book by statins and rhabdomyolysis Marino
  • Procedures and Techniques in Intensive Care Medicine by Irwin and Rippe
  • Pathogenesis and treatment of renal dysfunction in rhabdomyolysis, S. Holt, K. Moore, Intensive Care Medicine, Volume 27, Number 5, 803 - 811.
  • Pathogenesis and treatment of renal dysfunction in rhabdomyolysis, (reply) Panagiotis Korantzopoulos, Dimitrios Galaris, Dimitrios Papaioannides, Intensive Care Medicine, Volume 28, Number 8, 1185 - 1185.
  • The pathophysiology of altered calcium metabolism in rhabdomyolysis-induced acute renal failure. Interactions of parathyroid hormone, 25-hydroxycholecalciferol, and 1,25-dihydroxycholecalciferol, Llach F., Felsenfeld A. J., Haussler M. R. ,New Engl J Med 1981; 305:117-123, Jul 16, 1981.
  • Serum creatine kinase as predictor of clinical course in rhabdomyolysis: a 5-year intensive care survey, Arthur R. de Meijer, Bernard G. Fikkers, Marinus H. de Keijzer, Baziel G. M. van Engelen, Joost P. H. Drenth, Intensive Care Medicine, Volume 29, Number 7, 1121 - 1125.

External links

  • Baggaley, P.: Rhabdomyolysis.
  • Rhabdomyolysis. Medline Plus.
  • Craig, S.: Rhabdomyolysis. eMedicine.
  • Larbi, E.B. Drug-induced rhabdomyolysis
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