ck of > 26,ooo

  1. Had a guy admitted the other day with a ck of >26,000. :imbar HX. htn, and hyperlipidemia. took bp pill and zocor. He just started the zocor 2 months ago. (remember Baychol?) Anyway, he had just started an excersize regimen the previous day. Trainer decided he should start (start!) with 2 hours per day. The day of admission, he had just completed 1/2 hr of cardio workout, and was laying on the mat doing situps when he had a "near syncope" episode. (Dizzy, lightheaded, nausea). Brought to our ER by ambo. I asked the doc why he thought the CK would be so high? LFT's were elevated, CK-MB was 4.something. Trop was negative. Guy had absolutely no S/S whatsoever. Then I remembered baychol. Or baycol. Whatever. (nice pens). Looked it up on the internet, and found that any of the statins can cause rhabdo. Told the doc. pat self on back.

    Any others with CK's like this? with statins still on the market? I mean, the exercise might have contributed, but 2 days worth? Guy was mid 50's and weighted 243#.
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  2. 13 Comments

  3. by   suzanne4
    The only time I have seen CPKs in that range were from rhabdo and back then we didn't have all of these newer products. My patients had gotten it the old fashioned way; they were very, very sick.
    I will add your post to what I tell my students.
    Thanks for the info.
  4. by   gwenith
    Ditto and double ditto!!!

    Nice work!!!
  5. by   Tweety
    Good job! I learned something. I've seen a few cases of rhabdo, usually in patients who come in and were "found down" at home a long period of time. I had no idea it could be caused by a medication.
  6. by   teeituptom
    Quote from 3rdShiftGuy
    Good job! I learned something. I've seen a few cases of rhabdo, usually in patients who come in and were "found down" at home a long period of time. I had no idea it could be caused by a medication.

    also by McCardles syndrome, causes chronic Rhabdo

    I know apt on disability due to it
  7. by   Uptoherern
    http://members.aol.com/itsgumby/About.html

    ok, so then I had to look up Mcardle's syndrome

    Amazing, day to day, that despite how much you think you know........everyday there is something new. Not like that job that Lucy had with the chocolates on the conveyor belt. :chuckle
  8. by   veetach
    Congrats Diane! Great call!
  9. by   qc rn
    Good call..I love when we can show the docs how smart we are. I work at an urgent care department. Last week we had a new doc very smart but not used to fast pace and was hurried. We had a young female with some sob but had ok sats. I listened to her lungs and could hear nothingin the left side. Told the doc but she said the pt. was diminished and ordered a neb. tx befor a chest xray. Wellllll the chest xray showed a giant pneumo. I was proud yet embarrassed for the doc. Go figure....
  10. by   Uptoherern
    yet inside, don't you love that? I had a patient a long time ago that had been in the hospital for dx of pyelonephritis. she's been there for about a week . Looking at my MAR's at the beginning of the shift, I see IV fluids, nausea and pain meds...........no abx's! Looked back, and she had missed 48 hours of cipro iv because our pharmacy has a "hard stop" on certain abx, and will not fill until dr. writes new order for same. I had to call him and notify him of same. Could've held the phone 2 feet from my ear and still hear him rant. Had to remind him #1, I've not ever taken care of this patient before, #2, notes had been put on the chart for him to re-order med, and #3 it is only 1/2 hour into my shift! He appologized, and she got her cipro. (turns out she didn't even have pyelo in the first place, and was soon d/c'd) HA!
  11. by   Uptoherern
    Since I'm in this mode............I once had a post op patient that the doc wrote "ambulate tonoc, and the bid" My aide and I strugged to get this patient out of bed, made it to the door, barely, and back to bed. Found out (after we had tucked him in) that he had been a paraplegic almost all of his adult life, and was wheelchair bound. :imbar

    Then, had a post TURP pt. This doc always wrote the same orders on every one of his patients, so I knew I had to get him up into a chair that night after surgery. DId just that...........put him back to bed. Next day, I am getting my a## reamed by mister/doctor/shortman syndrome urologist because "the patient told me you did NOT get him up last night!" Well........... :angryfire I sure did! and had nursing assistant who helped me there to testify. The patient was still grogged from anesthesia and didn't even remember being in the chair! HA!
  12. by   moonshadeau
    Had a guy who had a level >80,000 for over three days but his was related to too many squats at the gym. Never seen a statin cause ck quite that high though.
  13. by   Stitchie
    Quote from 3rdShiftGuy
    Good job! I learned something. I've seen a few cases of rhabdo, usually in patients who come in and were "found down" at home a long period of time. I had no idea it could be caused by a medication.
    Tweety,

    Saw my first case of rhabo last week -- same scenario, pt FDWB, son found her about 8 hours down and she had a CK of >27,000.

    She had that rhabo urine color too -- weird. Love the ER. Learn so much every day.
  14. by   susanmary
    [
    Last edit by susanmary on Jan 14, '05

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