Acute alcoholic myopathy should be considered in patients who, after bingeing on alcohol, present with muscle pain that mostly involves limb weakness and myoglobinuria. Significance of acute alcoholic myopathy is that the precipitation of myoglobin in the renal tubules can cause acute renal tubular necrosis. Aggressive hydration and, occasionally, administration of mannitol and furosemide to increase diuresis, are essential to maintain renal function. Alcohol, in addition to the acute syndrome of muscle necrosis, causes a more chronic myopathy associated with gradual progressive weakness and atrophy that usually involves the hip and shoulder girdle. AZT Lovastatin Cocaine Colchicine Acute periodic paralysis may be classified as hypokalemic, hyperkalemic, or normokalemic.
Normokalemic paralysis causes the most severe and prolonged attacks.
A genetic defect has been linked to these diseases, but in some instances, hypokalemia may cause acute weakness in healthy individuals. This may occur independent of the sodium-potassium pump. Familial periodic paralysis usually occurs in Caucasian males, is autosomal dominant, and may last as long as 36 hours. Attacks usually occur at night or in early morning upon awakening and can be precipitated by a diet high in carbohydrates, rest following exercise, or glucose and insulin given intravenously. Treatment of the underlying disease and electrolyte disorder are curative.