PMID: 8968457Dec 1, 1996Paper

Acute myopathy associated with combined use of corticosteroids and neuromuscular blocking agents

The Annals of Pharmacotherapy
J R Fischer, R K Baer

Abstract

To review the occurrence and pathophysiology of myopathy associated with combined use of neuromuscular blocking agents (NMBAs) and systemic corticosteroids. A MEDLINE search (1985 to July 1995, English language) yielded case reports and clinical studies involving myopathy or weakness associated with the use of NMBAs and/or corticosteroids. References cited in those articles were reviewed. Prolonged muscle weakness has been reported in intubated patients in the intensive care unit (ICU) who were receiving NMBAs and/or corticosteroids. Many cases involved the use of both agents in individuals with no underlying risk factors. The term "blocking agent-corticosteroid myopathy" (BACM) has been used to describe this myopathy when it develops following combined use of these agents. Features common to BACM include prolonged weakness, elevated creatine kinase concentrations, myopathic features on electromyography, normal nerve conduction and sensation, and reduced deep tendon reflexes. Muscle biopsy results vary, but tend to show type 1 and/or 2 fiber atrophy without inflammation. Some recently reported cases revealed thick myosin myofilament loss, which is consistent with findings in denervated rat muscle after exposure to corticosteroi...Continue Reading

Citations

Nov 24, 1999·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·A HökeD W Zochodne
Oct 19, 2013·European Journal of Anaesthesiology·Stefan SoltészThomas Mencke
Oct 6, 1999·American Journal of Respiratory and Critical Care Medicine·M A Jantz, S A Sahn
May 3, 2012·American Journal of Respiratory and Critical Care Medicine·Zudin PuthuchearyNicholas Hart
Jul 22, 1998·Critical Care Medicine·N A DavisA A Fowler
Oct 16, 2004·Expert Review of Anti-infective Therapy·Deepthi Attygalle, Nalini Rodrigo
Dec 2, 2005·European Journal of Anaesthesiology·E N RobertsonG J Scheffer
Dec 17, 2005·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Arthur J Newman, Nora G Singer
Feb 10, 2000·Critical Care Medicine·M Zwienenberg, J P Muizelaar
Oct 26, 2002·The Annals of Pharmacotherapy·Bryan W PolsonettiLuis F Laos
Aug 23, 2001·British Journal of Anaesthesia·T M CookJ M Handel

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