Statin Myopathy

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a*onDepartmentUniversityofBridgeport operlyrecordthefindings. earningObjec*ves /diagnosisofpiriformissyndrome. hyandpiriformissyndrome.OpeningStatement MyopathyMyopathy efiber. Diagnosisisthekeytosuccessfultreatment! �ness,andspasm.1

ascularDisease Sta*ns(orHMG- wercholesterollevelsbyinhibi*ngtheenzymeHMG- entoftotalcholesterolinthebody. oodpressure:ameta- 9.CoronaryArteryDisease rdiovasculardisease(CVD). oodpressure:ameta- 9.CoronaryHeartDisease Hydroxymethylglutaryl- ‐coenzymeA(HMG- onaryheartdiseaseandatherosclerosis.2

1/28/15AngioplastyPreandPostStentImages ��owthroughtheartery.BenefitsofSta*ns farteriesleadingtotheheartorbrain. JOHND.ABRAMSON.HarvardSchoolofMedicineCaveatEmptor uallyreducecardiovasculardisease. e,anunhealthydiet,andotherlifestylefactors. er13,2013AdverseDrugReac*ons ociatedwithHMG- olesterolaemiaisofparamountimportance. ;5(5):651- ‐66.PhysicianDenialEighty- eirsymptom.3

1/28/15PhysicianDenial pathysurvey,86%vs14%musclesurvey;p 10(- ‐8)foreach). thepossibilityofaconnec*on. eporters,poten*allyspeedingrecogni*onofADRs. 30(8):669- geffects:implica*onsforpa*ent- ‐targetedadverseeffectsurveillance.Muscle- ‐RelatedAdverseEffects(MAE) Threehundredfiry- ‐fourpa*ents(agerange34- ‐86yrs)whoself- ‐reportedmuscle- ngratesMuscle- ‐RelatedAdverseEffects(MAE) Pa*entswithperceivedsta*n- e(QOL). Pharmacotherapy.2010Jun;30(6):541- ‐53.QualityofLifeMuscle- ‐RelatedAdverseEffects(MAE) ose'withoutwhichnomemberofthehumanracecanbehappy.' p 0.01). ks);someMAEsoccurredarerlong- ‐termsymptom- ‐freeuse. earch2,pp229- ‐248. ChamS,EvansMA,DenenbergJO,GolombBA.Sta*n- ‐associatedmuscle- Pharmacotherapy.2010Jun;30(6):541- ‐53.4

1/28/15Muscle- ‐RelatedAdverseEffects(MAE) latencytoonset(median2wks). Ldomains.Muscle- ‐RelatedAdverseEffects(MAE)CONCLUSION: Thedataindica*ngadose- sidera*onforameliora*ngsymptoms. ChamS,EvansMA,DenenbergJO,GolombBA.Sta*n- ‐associatedmuscle- Pharmacotherapy.2010Jun;30(6):541- ‐53. Muscle- uralhistoryofsta*n- - ‐associatedmuscle- Pharmacotherapy.2010Jun;30(6):541- ‐53.CaseReport A63year- ermanentheartdamage.5

y2- lepainsandpiriformissyndromePiriformisSyndrome some*mesintothemedialfoot. osisandtreatment.MuscleNerve.2009;40(1):10- ‐18.doi:10.1002/mus.21318.ClinicalChallenge ptomsofPiriformisSyndrome tandfromseatedorsquawngposi*on b Changeofposi*ondoesnotrelievepaincompletely Increasingpainarersiwngforlongerthan15- ‐20minutes(mostcommonsymptom)6

1/28/15SymptomsofPiriformisSyndrome Syndrome Sta*nholidayanddetermineresponse response sponse on*nueandswitchtoniacin andatorySignsofPiriformisSyndrome formismuscle Palpablemassinipsilateralbu]ock Asymmetricalweaknessofaffectedlimb ysigns Ipsilateralleglengthinequality Glutealatrophy(chroniccasesonly)Discussion talcondi*onsandtakingsta*nmedica*ons ClosingStatement Diagnosisisthekeytosuccessfultreatment!7

1/28/15 6 Muscle(Pain(and(Piriformis(Syndrome(Approximately& 2_4&weeks&post surgery&the& paent experienced& severemuscle& pai

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