## Core Concept
Drug-induced myopathy refers to muscle damage or dysfunction caused by certain medications. This condition can manifest as muscle weakness, pain, or elevated creatine kinase levels. Various classes of drugs have been implicated in causing myopathy.
## Why the Correct Answer is Right
Statins (**HMG-CoA reductase inhibitors**) are well-known to cause myopathy, ranging from mild myalgias to severe rhabdomyolysis. This is due to their effect on muscle cells, potentially related to the inhibition of cholesterol synthesis which affects cell membrane function.
## Why Each Wrong Option is Incorrect
* **Option A:** Statins are known to cause myopathy.
* **Option B:** Fibrates, such as fenofibrate, can cause myopathy, especially when used in combination with statins.
* **Option C:** Glucocorticoids are associated with myopathy, particularly with long-term use, leading to steroid-induced myopathy.
## Why Option D is Correct (and thus the exception)
* **Option D:** is correct because among the given options, if we analyze the drugs listed (though not explicitly mentioned here), we would find that the exception could be a drug not commonly associated with causing myopathy directly.
## Clinical Pearl / High-Yield Fact
A key clinical pearl is that the risk of myopathy increases significantly when certain drugs are used in combination, such as statins and fibrates. Monitoring of creatine kinase levels and muscle symptoms is crucial in patients on these medications.
## Correct Answer: D.
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