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1. Which ONE of the following is TRUE?
a) Fluvastatin is associated with the
greatest risk for myopathy.
b) Simvastatin 10 mg is more likely to
cause myopathy than simvastatin 40
c) Amiodarone is likely to reduce the risk
of statin-induced myopathy.
d) Pravastatin can be used in simvastatin
2. Which ONE of the following is TRUE?
a) Statins are associated with muscle
weakness and falls.
b) Statin-induced myopathy is more likely
to present as generalized myalgia.
c) Statin-induced myopathy can be
treated with grapefruit.
d) Statin-induced myopathy is more
common in Asians.
3. Which ONE of the following is TRUE?
a) Methotrexate and prednisolone have
no role in treatment of statin-induced
b) Black Americans are more likely to
have raised baseline creatine kinase
c) There is not a variation in the general
definition of myopathy.
d) It is recommended to check vitamin D
levels in patients with myopathy.
4. Which ONE of the following is TRUE?
a) Ezetimibe is not associated with
b) Colchicine is associated with myopathy
independent of statin use.
c) Rosuvastatin dosed twice weekly
d) Coenzyme Q10 has no evidence for
improving statin-induced myopathy.
5. Which ONE of the following is TRUE?
a) Simvastatin has a higher risk of
myopathy when dosed at 40 mg.
b) Athletes are particularly sensitive to
c) Thighs and calves are the least affected
sites in statin-induced myopathy.
d) SLCO1B1 polymorphism is not
associated with statin-induced
18. Wilke RA, Ramsey LB, Johnson SG, et al. The clinical
pharmacogenomics implementation consortium: CPIC
guideline for SLCO1B1 and simvastatin-induced myopathy.
Clin Pharmacol Ther 2012;92:112–7 .
19. Liao JK. Safety and efficacy of statins in Asians. Am J Cardiol
20. Australian Medicines Handbook. Rosuvastatin. In; Accessed
Sep 9, 2013.
21. Chang CH, Kusama M, Ono S, Sugiyama Y, Orii T, Akazawa M.
Assessment of statin-associated muscle toxicity in Japan: a
cohort study conducted using claims database and laboratory
information. BMJ Open 2013;3.
22. Hippisley-Cox J, Coupland C. Predicting risk of emergency
admission to hospital using primary care data: derivation and
validation of QAdmissions score. BMJ Open 2013;3:e003482.
23. Gabb GM, Vitry A, Limaye V, Alhami G. Serious statin-associated
myotoxicity and rhabdomyolysis in Aboriginal and Torres Strait
Islanders: a case series. Intern Med J 2013;43:987–92.
24. Parker BA, Capizzi JA, Grimaldi AS, et al. Effect of statins on
skeletal muscle function. Circulation 2013;127:96–103.
25. Fedacko J, Pella D, Fedackova P, et al. Coenz yme Q(10) and
selenium in statin-associated myopathy treatment. Can J
Physiol Pharmacol 2013;91:165–70.
26. DiNicolantonio JJ. CoQ10 and L-carnitine for statin myalgia?
Expert Rev Cardiovasc Ther 2012;10:1329–33 .
27. Kuncl RW. Agents and mechanisms of toxic myopathy. Curr
Opin Neurol 2009;22:506–15.
28. Osterberg L, Blaschke T. Adherence to medication. N Engl J
29. Abd TT, Jacobson TA. Statin-induced myopathy: a review and
update. Expert Opin Drug Saf 2011;10:373–87.
30. Coco TJ, Klasner AE. Drug-induced rhabdomyolysis. Curr Opin
31. Armour R, Zhou L. Outcomes of statin myopathy after statin
withdrawal. J Clin Neuromuscul Dis 2013;14:103–9 .
32. Daskalopoulou SS. When statin therapy stops: implications for
the patient. Curr Opin Cardiol 2009;24:454–60 .
33. Taylor F, Huffman MD, Macedo AF, et al. Statins for the primary
prevention of cardiovascular disease. The Cochrane database
of systematic reviews 2013;1:CD004816.
34. Desai DA, Zakaria S, Ouyang P. Initiation of statin therapy: are
there age limits? Curr Atheroscler Rep 2012;14:17–25 .
35. Hilmer SN, Gnjidic, D. Statins in older adults. Australian
36. Gnjidic D, Le Couteur DG, Blyth FM, et al. Statin use and clinical
outcomes in older men: a prospective population-based study.
BMJ Open 2013;3.
37. Keating AJ, Campbell KB, Guyton JR. Intermittent nondaily
dosing strategies in patients with previous statin-induced
myopathy. Ann Pharmacother 2013;47:398–404.
38. Marcus FI, Baumgarten AJ, Fritz WL, Nolan PE, Jr. Alternate-day
dosing with statins. Am J Med 2013;126:99–104.
39. Yigit F, Muderrisoglu H, Guz G, et al. Comparison of
intermittent with continuous simvastatin treatment in
hypercholesterolemic patients with end stage renal failure. Jpn
Heart J 2004;45:959–68 .
40. Marcoff L, Thompson PD. The role of coenzyme Q10 in statin-
associated myopathy – A systematic review. J Am Coll Cardiol
41. Parker BA, Gregory SM, Lorson L, Polk D, White CM, Thompson
PD. A randomized trial of coenz yme Q10 in patients with
statin myopathy: rationale and study design. J Clin Lipidol
42. Bove A, Bellini M, Battaglia E, et al. Consensus statement AIGO/
SICCR diagnosis and treatment of chronic constipation and
obstructed defecation (Part II: Treatment). World J Gastroentero
43. Morales MA, Hernandez D, Bustamante S, Bachiller I, Rojas A. Is
senna laxative use associated to cathartic colon, genotoxicity,
or carcinogenicity? J Toxicol 2009;2009:287247.
44. Fazio S. Management of mixed dyslipidemia in patients with or
at risk for cardiovascular disease: a role for combination fibrate
therapy. Clin Ther 2008;30:294–306.
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