# Review the daptomycin treatment trend and determine the priority interpretation and action.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=516667&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

Review the daptomycin treatment trend and determine the priority interpretation and action.

| Time | Data |
| --- | --- |
| Before therapy | CPK 88 U/L; creatinine clearance 46 mL/min; no muscle pain; simvastatin listed as a home medication |
| Day 3 | CPK 310 U/L; mild thigh aching; creatinine clearance 42 mL/min |
| Day 5 | CPK 1480 U/L; new proximal weakness and dark urine; next dose due in 1 hour |

Q1. Which complication is most likely?

Expected antimicrobial response
Daptomycin-associated myopathy with possible rhabdomyolysis
Isolated dehydration without drug involvement

Q2. Which action is the priority?

Give the next dose and recheck CPK next month
Use daptomycin to treat a new pneumonia
Hold the dose and notify the authorized team for urgent toxicity and regimen review

## Explanation

New proximal muscle pain and weakness with a marked CPK increase during daptomycin therapy suggests myopathy; hold the dose and obtain prompt prescriber and pharmacist evaluation while reviewing renal function and concurrent statin use.

## In-depth explanation

Quick answer
The trend supports daptomycin-associated muscle toxicity.

Why this is correct
The label directs CPK and symptom monitoring, with more frequent assessment in renal impairment or concurrent HMG-CoA reductase inhibitor use. New weakness and a substantial CPK rise require immediate review.

Easy analogy or mental picture
The muscle warning light and laboratory gauge are rising together.

Memory hook
Daptomycin plus weakness plus rising CPK: hold and review.

NCLEX decision rule
Evaluate symptoms, CPK direction, renal clearance, interacting myotoxic drugs, and infection-treatment alternatives together.

Why the other choices are wrong
Ignoring the trend risks rhabdomyolysis, while using daptomycin for pneumonia conflicts with its labeled limitation.References
1DailyMed: Daptomycin for InjectionCPK and muscle-symptom monitoring, renal considerations, statin review, and nonindication for pneumonia

## Clinical scenario

Daptomycin safety trend
Assess muscle symptoms, CPK, creatinine clearance, urine findings, statin exposure, infection response, and the replacement antimicrobial plan.

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