Risk Factors for Rhabdomyolysis

 

Drugs with potential for abuse:

(1) alcohol, especially after a binge

(2) cocaine

(3) phencyclidine (PCP)

(4) heroin or opiates

(5) barbiturates

(6) amphetamines

 

Therapeutic drugs:

(1) isoniazid

(2) statins

(3) tricyclic antidepressants

(4) serotonergic drugs

(5) monoamine oxidase inhibitors

(6) neuroleptic agents (neuroleptic malignant syndrome)

(7) succinylcholine (malignant hyperthermia)

(8) inhalation anesthetics (malignant hyperthermia)

(9) thiazide diuretics (associated with hypokalemia

(10) salicylate poisoning (with hyperthermia)

(11) corticosteroids

(12) hypersensitivity reaction to antibiotics or other drugs

(13) quinidine

(14) central anticholinergic syndrome

(15) phenytoin

(16) phenylbutazone

 

Toxins:

(1) organic solvents

(2) carbon monoxide

(3) venoms

(4) toxic mushrooms (Tricholoma Equestre)

(5) cyanide

(6) hydrogen sulfide

(7) phosphine

(8) heavy metals

(9) chlorphenoxy herbicides

 

Metabolic:

(1) severe potassium depletion with hypokalemia

(2) phosphorus depletion

(3) magnesium depletion

(4) hyper or hyponatremia

(5) diabetic ketoacidosis

(6) hyper or hypothyroidism

(7) hyperaldosteronism

(8) hypoxemia

(9) hereditary enzyme defect in carbohydrate or lipid metabolism

 

Vascular:

(1) arterial thrombosis and limb ischemia

(2) extensive venous thrombosis

(3) ischemia-reperfusion injury

(4) cardiac arrest

(5) gangrene

(6) vasculitis

(7) air embolism

(8) sickle cell anemia

 

Temperature-related:

(1) hypothermia

(2) severe hyperthermia (including drug-induced, above)

(3) high environmental temperatures with high humidity

 

Infection:

(1) sepsis

(2) toxic shock syndrome

(3) tetanus

(4) Rocky Mountain Spotted Fever (RMSF)

(5) legionellosis

(6) infectious mononucleosis

(7) trichinosis

(8) influenza-like illness

 

Muscle damage:

(1) extensive blunt trauma

(2) compartment syndrome

(3) crush injury or muscle compression while obtunded or comatose

(4) prolonged or recurrent seizure activity

(5) exertion or vigorous exercise

(6) polymyositis or dermatomyositis

(7) thermal burn

(8) electrical injury

(9) myopathy or muscular dystrophy