Question
An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes for follow-up, with complaints of muscle pains. Which one of the following drugs could be the most likely cause?
The correct answer is
Atorvastatin
Muscle Pain: Identifying the Likely Drug Cause
A patient with a history of Diabetes mellitus and Coronary Artery Disease (CAD) presents with muscle pains. We need to identify the medication most likely responsible.
Drug Side Effect Analysis
Several common medications are used to manage conditions like diabetes and CAD. It's important to consider their known side effects:
- Aspirin: Primarily used as an antiplatelet agent to prevent blood clots in CAD. While it has side effects, severe muscle pain is not a typical common adverse effect.
- Glimepiride: An oral medication for Diabetes mellitus. Its main side effects relate to blood sugar levels (hypoglycemia) and gastrointestinal issues. Muscle pain is not commonly associated.
- Enalapril: An ACE inhibitor used for hypertension and heart conditions associated with CAD. While muscle aches can occur, they are less frequent compared to other side effects like cough.
- Atorvastatin: A statin medication used to lower cholesterol, commonly prescribed for patients with CAD to reduce cardiovascular risk. A well-documented and relatively common side effect of statins is myalgia (muscle pain), which can sometimes indicate more severe muscle damage (myopathy).
Drug Comparison Table
| Drug Name | Common Use | Potential for Muscle Pain |
|---|---|---|
| Aspirin | Antiplatelet (CAD) | Rare |
| Glimepiride | Diabetes Mellitus | Rare |
| Enalapril | Hypertension, CAD | Uncommon |
| Atorvastatin | Hyperlipidemia (CAD) | Common |
Conclusion on Muscle Pain Cause
Given the common side effect profile of these medications, Atorvastatin is the most likely drug causing the patient's muscle pains due to its association with statin-induced myalgia.
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Important Questions from Ischemic Heart Disease
- Which amongst the following should be considered in a patient with acute chest pain and ST segment elevation in the precordial leads?
1. Acute myocardial infarction
2. Acute hyperkalemia
3. Pericarditis
4. Hypocalcemia
5. Oesophagitis
6. Pneumothorax
Select the correct answer using the code given below. - Which amongst the following is the most powerful independent risk factor for atherosclerosis?
- A 40-year old woman presents with sudden onset palpitations. An ECG done reveals narrow-QRS complex tachycardia. The most likely diagnosis is:
- All of the following are indications for treadmill testing/exercise-testing EXCEPT:
- A 70 year old man reports to the emergency with acute chest pain. ECG shows inferior wall Myocardial Infarction (MI). He has recently been discharged 7 days back following thrombolysis with streptokinase for Acute Anterior wall MI. What will be the appropriate management?
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