Myopathy for the general internist: Statins and much more
1Myositis Center, Department of Medicine; Professor of Medicine, University of Pittsburgh, Pittsburgh, PA cvo5@pitt.edu.
Cleveland Clinic Journal of Medicine
|October 10, 2019
Summary
General practitioners can effectively manage patients with muscle diseases. This review covers statin use, creatine kinase (CK) interpretation, and identifying common and dangerous myopathies.
Area of Science:
- Neurology
- General Practice
Background:
- Muscle diseases present a diagnostic challenge for primary care physicians.
- Early recognition and management are crucial for patient outcomes.
Observation:
- This article focuses on the initial evaluation of patients with suspected myopathies.
- It addresses the specific considerations for patients undergoing statin therapy.
Findings:
- Guidance is provided on interpreting creatine kinase (CK) levels in the context of muscle disease.
- Key features of common and serious myopathies are outlined for primary care settings.
Implications:
- Empowering general practitioners to better diagnose and manage myopathies improves patient care.
- This resource aids in the timely referral of complex cases, optimizing treatment strategies.
Related Concept Videos
Lipid-Lowering Drugs: Statins and Miscellaneous Agents
1.3K
Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
1.3K
Myasthenia Gravis: Overview and Treatment
2.7K
Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
2.7K
Disorders of the Skeletal Muscle
1.6K
The clinical conditions affecting the skeletal muscle tissue are broadly categorized as musculoskeletal and neuromuscular disorders.
Musculoskeletal disorders
Musculoskeletal disorders involve injuries and conditions affecting the skeletal muscles and associated connective tissues. These disorders can arise from acute biomechanical stresses or chronic overuse and can occur across different age groups. Common injuries include sprains, fractures, and muscular strains, often resulting from...
Musculoskeletal disorders
Musculoskeletal disorders involve injuries and conditions affecting the skeletal muscles and associated connective tissues. These disorders can arise from acute biomechanical stresses or chronic overuse and can occur across different age groups. Common injuries include sprains, fractures, and muscular strains, often resulting from...
1.6K
Myocarditis III: Medical Management
149
Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
149
Skeletal Muscle Relaxants: Adverse Effects
748
Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
Unlike...
748
Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin
1.0K
Directly acting muscle relaxants like dantrolene and botulinum toxin (BoNT) have distinct mechanisms and applications. Dantrolene, a hydantoin derivative, acts on the ryanodine receptor (RYR1) in skeletal muscle cells. RYR1 are calcium channels present at the sarcoplasmic reticulum membrane. In response to excitation, they release calcium ions from the sarcoplasmic reticulum to the cytosol. Calcium promotes actin-myosin-mediated contraction of muscles.
The binding of dantrolene to the RYR1...
The binding of dantrolene to the RYR1...
1.0K


