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Myopathy is usually a non-fatal muscle disease involving skeletal muscle weakness, tenderness and pain with the possibility of the plasma creatinine kinase elevation. There are many different types of myopathies, some of which are genetic, inflammatory, or related to endocrine dysfunction. Also, numerous drugs have been reported to possess myotoxic effect. The pathophysiological mechanisms for myotoxicity are diverse and, in many instances, unclear. Medications can have either a direct or an indirect adverse effect on muscle. The direct effect can be focal, as might occur secondary to a drug being injected into tissue, or generalized. Indirect toxic effects may result from the agent creating an electrolyte imbalance or inducing an immunological reaction. Muscle fibers may undergo necrosis as a result of the drug directly disrupting the sarcolemma, nuclear or mitochondria function, or that of other organelles. Generally the drug-induced myopathies are classified according to their presumed pathogenic mechanisms.
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