Definition
In the medical field, one speaks of rhabdomyolysis when the skeletal muscle cells undergo a serious rupture, most often following an injury; when muscle fibers die, numerous substances are released into the bloodstream, such as phosphate, potassium, creatinine, uric acid and myoglobin, leading to a series of problems for the body (eg renal failure due to accumulation of myoglobins in the kidneys).
Causes
A injured muscle that releases large amounts of harmful / harmful substances in the blood generates rhabdomyolysis. Muscle injuries can be favored by: pathologies (eg asthma, bacterial / viral infections, diarrhea and vomiting, diabetes, hyperthyroidism), too high basal temperature / hypothermia, extreme sports (bodybuilding), endurance sports (marathon), burns, electric shock and drug addiction. Even the (excessive) administration of some drugs can promote rhabdomyolysis: acetylsalicylic acid, drugs for the treatment of high cholesterol, antibiotics.
Symptoms
Among the first signs of rhabdomyolysis, the reddish color assumed by the urine stands out, a sign of the presence of the myoglobin pigment. Other symptoms include: mood alteration, mental confusion, muscle contusion, nausea, respiratory problems, tachycardia. From the blood tests, the patient suffering from rhabdomyolysis records a marked or sensitive alteration of the levels of potassium, calcium, myoglobin, nitrogen and uric acid in the blood.
- Complications: renal failure, kidney damage, coagulation disorders, cardiac and pulmonary changes, death (cases of extreme severity)
Information on rhabdomyolysis - drugs for the treatment of rhabdomyolysis is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking rhabdomyolysis - drugs for the treatment of rhabdomyolysis.
drugs
Given the complications and risks derived from rhabdomyolysis, the need for immediate intervention is evident, right from the earliest symptoms. In order to prevent damage caused by the release of myoglobin in the blood, intravenous fluid administration (rehydration) is indicated. The increase in fluids favors the elimination of myoglobin from the kidneys, thus preventing the risk of kidney damage.
In addition to liquids, some active ingredients can be added to the hydration therapy: sodium bicarbonate and mannitol.
Sodium bicarbonate (NaHCO 3 ) is indicated for reducing the acidity of urine, as well as the harmful effects of myoglobin in the kidneys; Mannitol (eg Osmohale, Man10% BIN, Isotol) and other diuretics favor the elimination of water, "cleaning" the kidneys from harmful substances. Furosemide (eg Lasix) is a diuretic drug widely used for this purpose: in general, the recommended dose of furosemide must be such as to favor a urination of 100ml / hour.
If the hydration therapy is not sufficient to restore the serum values of potassium, calcium, nitrogen, uric acid and myoglobin, the doctor will choose one of the following treatment options:
- Hemodialysis: very useful for filtering blood and retaining substances that would cause damage. Reserved for severe cases of rhabdomyolysis.
- Blood transfusion
- Surgery: the surgical treatment for rhabdomyolysis is called fasciotomy; it is a therapeutic strategy in which the muscular lining tissues are cut to reduce the pressure inside the blood vessels, exerted by the swelling and pain of the damaged muscle.
Notes: the administration of statins (a cholesterol-lowering drug), especially when combined with antibiotics such as clarithromycin, greatly increases the risk of rhabdomyolysis; therefore, those who follow a similar therapy are recommended to undergo regular blood tests to eventually intervene promptly. In this case, it is advisable to stop treatment with statins, replacing the drug with an alternative one.
