| Consecuencias de la administración de succinilcolina a pacientes usando estatinas |
Consequences of succinylcholine administration to patients using statins. Turan A, Mendoza ML, Gupta S, You J, Gottlieb A, Chu W, Saager L, Sessler DI. Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA. alparslanturan@yahoo.comAnesthesiology. 2011 Jul;115(1):28-35.Abstract BACKGROUND: Statins cause structural changes in myocytes and provoke myotoxicity, myopathy, and myalgias. Thus, patients taking statins may be especially susceptible to succinylcholine-induced muscle injury. The authors tested the hypothesis that succinylcholine increases plasma concentrations of myoglobin, potassium, and creatine kinase more in patients who take statins than in those who do not and that succinylcholine-induced postoperative muscle pain is aggravated in statin users. METHODS: Patients who took statins for at least 3 months and those who had never used statins were enrolled. General anesthesia was induced and included 1.5 mg/kg succinylcholine for intubation. The incidence and degree of fasciculation after succinylcholine administration were recorded. Blood samples were obtained before induction and 5 and 20 min and 24 h after succinylcholine administration. Patients were interviewed 2 and 24 h after surgery to determine the degree of myalgia. RESULTS: The authors enrolled 38 patients who used statins and 32 who did not. At 20 min, myoglobin was higher in statin users versus nonusers (ratio of medians 1.34 [95% CI: 1.1, 1.7], P = 0.018). Fasciculations in statin users were more intense than in nonusers (P = 0.047). However, plasma potassium and creatine kinase concentrations were similar in statin users and nonusers, as was muscle pain. CONCLUSIONS: The plasma myoglobin concentration at 20 min was significantly greater in statin users than nonusers, although the difference seems unlikely to be clinically important. The study results suggest that the effect of succinylcholine given to patients taking statins is likely to be small and probably of limited clinical consequence http://journals.lww.com/anesthesiology/pages/articleviewer.aspx?year=2011&issue=07000&article=00013&type=abstract |
| La succinilcolina debe de evitarse en pacientes con terapia con estatinas |
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| Miopatías inducidas por estatinas |
Statin-induced myopathies.
Tomaszewski M, Stępień KM, Tomaszewska J, Czuczwar SJ.
Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, PL 20-954 Lublin, Poland. mdtomaszewski@yahoo.com
Pharmacol Rep. 2011;63(4):859-66.
Abstract
Statinsare considered to be safe, well tolerated and the most efficient drugs for the treatment of hypercholesterolemia, one of the main risk factor for atherosclerosis, and therefore they are frequently prescribed medications. The most severe adverse effect of statins is myotoxicity, in the form of myopathy, myalgia, myositis or rhabdomyolysis. Clinical trials commonly define statin toxicity as myalgia or muscle weakness with creatine kinase (CK) levels greater than 10 times the normal upper limit. Rhabdomyolysis is the most severe adverse effect of statins, which may result in acute renal failure, disseminated intravascular coagulation and death. The exact pathophysiology of statin-induced myopathyis not fully known. Multiple pathophysiological mechanisms may contribute to statin myotoxicity. This review focuses on a number of them. The prevention of statin-related myopathy involves using the lowest statin dose required to achieve therapeutic goals and avoiding polytherapy with drugs known to increase systemic exposure and myopathy risk. Currently, the only effective treatment of statin-induced myopathy is the discontinuation of statin use in patients affected by muscle aches, pains and elevated CK levels.
http://www.if-pan.krakow.pl/pjp/pdf/2011/4_859.pdf |
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