Remember: These 6 Drugs Can Cause Rhabdomyolysis!

Author: Gcplive

Source: Center for Drug Evaluation< /p>In recent years, reports of rhabdomyolysis caused by heavy consumption of crayfish, heavy drinking, and excessive exercise have frequently appeared in people’s field of vision. In fact, more than 80% of rhabdomyolysis cases are caused by drugs! I. What is Creatine Kinase (CK)? Under normal circumstances, the vast majority of creatine kinase (CK) is located in muscle cells. Elevated levels of creatine kinase in the blood generally indicate muscle damage or muscle damage is occurring. Creatine kinase has a variety of isozymes, and the CK-MB type mainly exists in cardiomyocytes. In myocardial infarction, CK-MB, the isoenzyme of creatine kinase, is elevated. CK-MB/CK<5%, common in skeletal muscle lesions; CK-MB/CK≥6% is a specific indicator of myocardial injury. Second, what is rhabdomyolysis? According to the difference in the shape and distribution of muscle cells, muscle tissue is divided into three categories: skeletal muscle, cardiac muscle and smooth muscle. The muscle fibers of skeletal muscle and cardiac muscle are striated, so it is also called striated muscle. Smooth muscle fibers without striations. rhabdomyolysis syndrome: means rhabdomyolysis after cell damage The integrity of the cell membrane is altered, and the substances within the muscle cells are released into the interstitial space or blood, resulting in a series of clinical syndromes. The most classic triad of rhabdomyolysis: myalgia, muscle weakness, and brown urine. Severe cases, accompanied by acute renal failure. III. The main causes of rhabdomyolysis syndromeThe main causes of rhabdomyolysis syndrome can be divided into physical factors and non-physical factors. Physical factors include crush injury, strenuous exercise, etc.; non-physical factors include drugs, alcohol, hypokalemia, etc. 4. Drugs that can cause rhabdoid syndrome1.Statins The commonly used statins include lovastatin, simvastatin, pravastatin, pitavastatin, atorvastatin, rosuvastatin, etc. . The incidence of myopathy caused by statins is about 1.5%-5%, and the incidence of rhabdomyolysis syndrome is 0.04%-0.2%. Patients should seek medical attention in time if they have unexplained muscle pain, tenderness or weakness during the medication. 2. fibrate lipid-lowering drugsCommonly used drugs include fenofibrate, gemfibrozil, benzene Zabbet, clofibrate, etc., the main role is to reduce triglyceride. Fibrates can cause myositis, myopathy, and rhabdomyolysis syndrome. Patients with renal insufficiency or hyperthyroidism are at increased risk of developing myopathy. 3. Quinolone antibioticsThe commonly used quinolone antibiotics are norfloxacin, ciprofloxacin , levofloxacin, moxifloxacin, etc. Quinolones are cartilage toxic and are contraindicated in children under the age of 18! Quinolones can cause adverse reactions in the musculoskeletal system, including arthralgia, Achilles tendinitis, tendonitis, tendon rupture, muscle weakness, myalgia, and rhabdomyolysis. 4. Drugs that cause hypokalemiaHypokalemia is a risk factor for rhabdomyolysis syndrome. Under normal circumstances, when a muscle contracts, potassium ions enter the cells, dilating blood vessels and increasing blood flow to the muscle during exercise. In hypokalemia, sustained muscle contractions can lead to ischemia and muscle necrosis. Many drugs that cause hypokalemia can cause muscle damage, such as furosemide, hydrochlorothiazide, amphotericin B, and compound glycyrrhizin. 5. Psychotropic SubstancesAntipsychotics (chlorpromazine, perphenazine, haloperidol, risperidone), antidepressants (amitriptyline, doxepin, fluoxetine, venlafaxine) , sedative-hypnotics (diazepam, nitrazepam, lorazepam), etc., have been reported to cause rhabdomyolysis. Psychotropic drugs cause rhabdomyolysis, which may be related to the lack of energy supply to muscle cells or direct damage to muscle cells caused by drugs. 6. Anti-gout drugsColchicine is mainly used for the treatment and prevention of acute gout. Colchicine is a mitotic inhibitor that induces apoptosis and is toxic to cells. In addition to myelosuppression, it can also cause muscle weakness, myalgia, increased creatine phosphokinase, and rhabdomyolysis. V. Accomplices of Rhabdomyolysis SyndromeAt least 20% of acute rhabdomyolysis is related to ethanol. Asymptomatic creatine kinase (CK) elevations and histological myopathy can be seen in healthy individuals who drink heavily.