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所在平台: Udemy |
课程主页: https://www.udemy.com/course/statins-in-the-musculoskeletal-landscape/
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**课程名称：** 他汀类药物与肌骨系统 **课程概述：** 本课程专为肌骨科临床医生设计，时长一小时，以严谨的循证医学为基础，深入探讨他汀类药物不耐受和他汀相关肌症状（SAMS）。课程旨在提高临床医生对由他汀类药物引起的患者肌肉疼痛和痉挛的认识。课程内容涵盖了SAMS的症状、风险因素、不同类型的他汀类药物、潜在的发病机制、最新的研究发现、诊断工具以及有效的管理策略。此外，课程还将探讨他汀类药物治疗的争议，以及其潜在的益处和风险。 **重要提示：** 本课程不建议指导患者停用他汀类药物，而是为医生提供识别和筛查患者的循证信息，以便转介给内科或心内科医生进行进一步评估。 **课程目标：** * 提高肌骨科患者中他汀类药物不耐受的认识和识别能力。 * 了解与他汀相关肌症状（SAMS）相关的风险因素。 * 识别肌炎/肌病的体征和症状。 * 理解SAMS的生理过程以及确诊的检查方法。 **课程大纲：** 1. **他汀类药物的肌肉疼痛和不耐受介绍** * 定义和患病率 * FDA对医生和患者的信息 * 他汀类药物的重要性 * 他汀类药物治疗的益处与风险 2. **他汀类药物概述：症状与风险因素** * 症状及可能的副作用 * 风险因素 3. **他汀类药物分类** * 脂溶性 * 水溶性 * 剂量讨论 4. **他汀类药物肌肉疼痛和不耐受的诊断** * 肌酸激酶（CK） * 诊断工具 * 他汀相关肌症状指数 * 梅奥诊所他汀不耐受服务 5. **安慰剂效应** * 安慰剂效应的讨论 * 预防安慰剂效应的方法 6. **国际血脂专家小组定位文件** * 文件发现和结果 7. **研究进展** * SAMS和低发病率研究原因 * STOMP研究（2013） * 《柳叶刀》报告（2022） * Davis等人荟萃分析（2021） * Bytuci I等人他汀不耐受患病率荟萃分析（2022） 8. **SAMS背后的机制** 9. **肌肉受累的等级** * 横纹肌溶解症 * 肌痛与轻度高CK血症 * 可自行消退的毒性他汀肌病 * 他汀相关自身免疫性坏死性肌病 10. **肌肉疼痛的鉴别诊断** * 免疫介导的肌病 * 其他可能诊断 11. **他汀类药物与肌腱病** 12. **药物和食物相互作用** 13. **康复中的他汀类药物应用** 14. **他汀类药物肌肉疼痛和不耐受病例研究** 15. **总结与结论** * 课程要点总结 * 测验 * 参考文献 **目标受众：** 医疗专业人士，非公众人士。
This is a one-hour heavily evidence-based inquiry designed for musculoskeletal clinicians on statin intolerance and SAMS or statin-associated muscle symptoms. Statin intolerance may affect certain individuals who are on statins with muscle pain and spasm. I was not aware of this issue until I had a patient four years ago with the strangest bilateral lower extremity muscle pain that eventually resolved when she went off the statin. I started researching the topic and was fascinated by the information and felt I needed to share it. Hence the development of this course.Statin intolerance may affect up to 9% of statin users. It is a very controversial subject. Some researchers and physicians say muscle symptoms are due to the nocebo effect and the beliefs of the patient that the drug is doing them harm and other researchers and physicians feel SAMS is a valid issue and the prevalence of SAMS is upwards of 20% of statin users. Even the Mayo Clinic has a statin intolerance clinic.This evidence-based inquiry course comprehensively explores statin muscle pain and intolerance for musculoskeletal healthcare professionals. It covers various topics, including symptoms, risk factors, types of statins, potential mechanisms, research findings, diagnostic tools, and effective management strategies. Additionally, the course delves into the controversies surrounding statin therapy, as well as the potential benefits and risks associated with the use of these medications.This course is not designed to tell your patients to stop taking statins It is designed to give you information to screen your patients and refer them to their physician or cardiologist for further investigation.This course is designed for medical professionals and not the general public.Goals and Objectives:Increase awareness and recognition of statin intolerance in musculoskeletal patients.Learn the risk factors associated with Statin Associated Muscle Symptoms (SAMS).Identify the signs and symptoms of myositis/myopathy.Understand the physiological process involved with SAMS and tests to confirm.Course Outline:I. Introduction to Statin Muscle Pain and Intolerance a. Definition and prevalence of statin muscle pain and intolerance b. FDA information for clinicians and patients c. Importance of statinsd. Benefits and risks of statin therapy2. Statin Overview of the symptoms and risk factors of statin muscle pain and intolerance a. Symptoms and possible side effects b. Risk factors3. Types of Statins a. Lipophilic b. Hydrophilicc. Dosage discussion4. Diagnosis of Statin Muscle Pain and Intolerance a. Creatine Kinase b. Diagnostic tools c. Statin-associated muscle symptom clinic index d. Mayo Clinic Statin Intolerance Service5. Nocebo Effect a. Discussion of the nocebo effect b. Ways to prevent the nocebo effect6. Position paper international lipid expert panel a. Paper findings and outcomes7. Research a. SAMS and low incidence reasons in research b. STOMP Study (2013) c. Lancet Report (2022) d. Meta-analysis Davis et al (2021) e. Meta-analysis prevalence of statin intolerance Bytuci I et al (2022)8. Mechanism behind SAMS9. Levels of Muscle Involvement a. Rhabdomyolysis b. Myalgia and Mild HyperCKemia c. Self-Limited Toxic Statin Myopathy d. Statin Associated Autoimmune Necrotizing Myopathy10. Differential Diagnosis of Muscle Pain a. Immune-mediated myopathies b. Other possible diagnoses11. Statins and Tendinopathy12. Drug and Food Interaction13. Statins in Rehabilitation14. Case study of a patient with statin muscle pain and intolerance15. Summary and Conclusions a. Summary of key concepts covered in the course b. Quiz c. References
