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A case of rosuvastatin-induced rhabdomyolysis: More is not better

2008· article· en· W2086019168 on OpenAlexvenueno aff
Trevor J. Simmons

Bibliographic record

VenueCanadian Pharmacists Journal / Revue des Pharmaciens du Canada · 2008
Typearticle
Languageen
FieldMedicine
TopicLipoproteins and Cardiovascular Health
Canadian institutionsnot available
Fundersnot available
KeywordsRosuvastatinRhabdomyolysisMedicineInternal medicine

Abstract

fetched live from OpenAlex

A 67-year-old female presented to the emergencydepartment with a 2-week history of progressivenausea, vomiting, abdominal pain, muscle cramps,and dehydration with an associated 3.6 kg weightloss. The patient had amedical history significantfor hypertension, hyperc-holesterolemia, myocardialinfarction, quadruple coro-nary artery bypass, asthma,and osteoarthritis. Medica-tions included enteric-coated acetylsalicylic acid81 mg daily, cilazapril 5 mgdaily, diltiazem CD 240 mgdaily, rosuvastatin 80 mgdaily, ezetimibe 10 mg daily,venlafaxine XL 75 mg daily,Advair (salmeterol/fluticasone) inhaler 250 mcg 1puff twice daily, Didrocal (calcium carbonate oretidronate) 1 tablet daily, glucosamine 1500 mgdaily, and ranitidine 150 mg twice daily. Vital signsat presentation included blood pressure 132/60mm Hg, heart rate 72 beats/minute, respiratoryrate 16 breaths/minute, and oxygen saturation 96%on room air. Abnormal findings on initial physicalexam indicated a mildly tender abdomen in all 4quadrants and reduced skin turgor, but the remain-der of the physical exam was unremarkable. Base-line laboratory tests indicated the following abnor-mal results: potassium 5.9 mmol/L, blood ureanitrogen 40.3 µmol/L, serum creatinine 1035µmol/L, creatine kinase (CK) 30,509 U/L, urinarymyoglobin >30,000 mcg/L, aspartate aminotrans-ferase 539 U/L, alanine aminotransferase 393 U/L,lactate dehydrogenase 1239 U/L. Urinalysis waspositive for red blood cellsand protein, and was nitritenegative, and a 12-leadelectrocardiogram indi-cated normal sinus rhythmwith no ischemic changes. Further history regard-ing the use of cholesterol-lowering agents revealedthe patient was initiated onsimvastatin 40 mg daily fol-lowing a myocardial infarc-tion 9 years previously, andwas switched to atorvas-tatin 20 mg daily 1 year later. The atorvastatin dosewas increased gradually over 4 years to 80 mg daily,but failed to achieve target low-density lipoproteincholesterol (LDL-C). Three years prior to presen-tation, ezetimibe 10 mg daily was added, whichresulted in an LDL-C reduction to 2.4 mmol/L.However, 7 months prior to presentation, atorvas-tatin 80 mg daily and ezetimibe 10 mg daily hadbeen inadequately controlling her cholesterol(LDL-C 2.9 mmol/L) and as a result atorvastatinwas switched to rosuvastatin 40 mg daily. Twomonths later, again due to inability to reach targetLDL-C, the dose of rosuvastatin was increased to

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.005
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Case report · Consensus signal: Case report
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.010
Threshold uncertainty score0.021

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.005
Meta-epidemiology (narrow)0.0030.002
Meta-epidemiology (broad)0.0020.002
Bibliometrics0.0030.003
Science and technology studies0.0040.002
Scholarly communication0.0020.004
Open science0.0020.003
Research integrity0.0100.006
Insufficient payload (model declined to judge)0.0040.001

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.054
GPT teacher head0.289
Teacher spread0.234 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designCase report
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations1
Published2008
Admission routes1
Has abstractyes

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