Rabdomiólise como efeito adverso ao uso de estatinas: uma revisão bibliográfica
DOI:
https://doi.org/10.34119/bjhrv6n4-053Keywords:
estatinas, efeitos adversos, rabdomióliseAbstract
Introdução: Dentre os sintomas musculares associados às estatinas (SMAE), a rabdomiólise é, frequentemente, a manifestação de pior prognóstico. Apesar de ser considerada rara, essa condição incorre em um alto nível de mortalidade e possui importante correlação com o tratamento das dislipidemias, já que as estatinas são medicamentos utilizados para essa comorbidade. Logo, o tema abordado tem demonstrado importância na prática clínica e na abordagem farmacológica. Objetivo: Realizar uma revisão bibliográfica acerca dos fatores de risco, manifestações clínicas, métodos diagnósticos e manejo da rabdomiólise induzida por estatinas. Metodologia: Revisão da literatura de caráter analítico e descritivo, seguimos parcialmente a metodologia PRISMA para catalogação dos resultados, sendo selecionados 91 artigos científicos dos quais apenas 44 literaturas foram incluídas na presente revisão. Os artigos foram selecionados a partir das bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scientific Eletronic Library Online (SCIELO) e National Library of Medicine (PUBMED). Resultado: A rabdomiólise, como reação colateral das estatinas, está bem documentada na literatura. Verifica-se que é uma condição rara e a mais letal das miopatias induzidas por estatinas, já que diversos fatores endógenos e exógenos atuam como potenciais aditivos ao risco de desenvolvimento dessa condição. O diagnóstico é essencialmente baseado nos níveis de Creatinofosfoquinase (CPK) e na sintomatologia adjacente, especialmente a Insuficiência Renal Aguda (IRA). O manejo terapêutico baseia-se na retirada da estatina, suporte clínico e monitoração. Conclusão: A rabdomiólise é uma condição rara, porém de grande relevância clínica por conta de suas graves repercussões. Sua relação com o uso de estatinas deve ser considerada quando a clínica for sugestiva, principalmente na presença de fatores de risco. A informação aos pacientes a respeito dos riscos envolvidos na terapia de estatinas pode ajudar na identificação da miopatia precocemente. Na presença de sintomas, o manejo é baseado na descontinuação do medicamento associado a medidas de suporte clínico. Além disso, deve-se considerar os diagnósticos diferenciais nos casos de não resolução.
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