Arthralgias

About 30% of the patients on chronic procainamide dosing develop a systemic lupusfike syndrome consisting of arthralgia, myalgia, skin rash, and fever. Patients who are slow acetylator phenotypes may be prone to this condition. Some may exhibit pleuropneumonic involvement and hepatomegaly... 

Antithyroid drags have several side effects. The most frequent side effects are maculopapular rashes, pruritus, urticaria, fever, arthralgia and swelling of the joints. They occur in 1-5% of patients [1, 2]. Loss of scalp hair, gastrointestinal problems, elevations of bone isoenzyme of alkaline phosphatase and abnormalities of taste and smell are less common. The incidence of all these untoward reactions is similar with MMI and PTU. Side effects of MMI are dose-related, whereas those of PTU are less clearly related to dose [1]. PTU may cause slight transient increases of serum aminotransferase and y-glutamyl transpeptidase concentrations but also severe hq atotoxicity whereas methimazole or carbimazole can be associated with cholestasis. The side... 

Headache, abdominal pain, arthralgia, recurrent bone pain, nausea, diarrhea, esophageal ulceration, dysphagia... 

Arthralgia (pain in the joints) may be noted for 1 or 2 days after the parenteral fonn is given. 

InFeD, generic anemia soreness and inflammation at injection site, chest pain, arthralgia, backache, convulsions, pruritus, abdominal pain, nausea, vomiting, dyspnea weight and grams percent (g/dL) of hemoglobin IV, IM... 

Hyperglycemia, hypoglycemia, nausea, diarrhea, upper respiratory tract infection, sinusitis, headache, arthralgia, back pain... 

Nausea, skin rash, pruritus, stomatitis, vomiting, anemia, leukopenia, neutropenia, arthralgia, alopeda, asthenia, fever, infections Diarrhea, nausea, vomiting, flushing, myalgia, arthralgia, fever, peripheral neuropathy, opportunistic infections Leukopenia, nausea, vomiting, paresthesias, malaise, weakness, mental depression, headache, hypertension, alopecia, diarrhea, constipation... 

Hypersensitivity reactions (rash, urticaria, arthralgia, respiratory distress, acute anaphylaxis), depression, somnolence, fatigue, coma, anorexia, nausea, vomiting... 

The most frequent adverse effects are local reactions at the injection site (pain, tenderness, erythema, swelling, and pruritus), fevers (greater than 37.5°C or 99.5°F), headaches, dizziness, and irritability. Anaphylaxis and hypersensitivity reactions have been reported rarely and occur within a few hours after vaccine administration. In rare instances, a serum sickness-like apparent hypersensitivity syndrome (arthralgia, urticaria, ecchymoses, erythema multiforme, and erythema nodosum) has been... 

The treatment goals for withdrawal from ethanol, cocaine/ amphetamines, and opioids include (1) a determination if pharmacologic treatment of withdrawal symptoms is necessary, (2) management of medical manifestations of withdrawal such as hypertension, seizures, arthralgias, and nausea, and (3) referral to the appropriate program for substance abuse treatment. 

Children treated with GH replacement therapy rarely experience significant adverse effects, whereas adults are more susceptible to dose-related adverse effects. Treatment with GH may mask underlying hypothyroidism. GH-induced symptoms, such as edema, arthralgia, myalgia, and carpal tunnel syndrome, are common and necessitate dose reductions in up to 40% of adults. Benign increases in intracranial pressure may occur with GH therapy and generally are reversible with discontinuation of treatment. Often, GH therapy can be restarted with smaller doses without symptom recurrence. 

Continuously monitor for dose-related adverse effects such as edema, arthralgia, myalgia, and carpal tunnel syndrome. 

O Common symptoms of menopause include hot flashes, night sweats, vulvovaginal atrophy, and vaginal dryness. Women less commonly may experience mood swings, depression, insomnia, arthralgia, myalgia, and urinary frequency. 

These reactions involve a serum sickness like syndrome (e.g., arthralgias, fever, malaise, and urticaria) that usually develops 7 to 14 days after exposure to the causative antigen. 

The most common adverse events reported with sirolimus are leukopenia (20%), thrombocytopenia (13% to 30%), and hyperlipidemia (38% to 57%).11,31 Other adverse effects include delayed wound healing, anemia, diarrhea, arthralgias, rash, and mouth ulcers. Sirolimus has an FDA black-box warning in newly transplanted liver and lung recipients.11 In liver transplant recipients, use of sirolimus immediately after transplant is associated with an increased risk of hepatic artery thrombosis, graft loss, and death. In lung transplant... 

Neuromuscular/skeletal Arthralgia Impaired growth Osteoporosis Skeletal muscle weakness... 

Parenteral iron anaphylaxis (test dose required for iron dextran and observe for 1 hour after), injection-site pain/ irritation, arthralgias, myalgias, flushing, malaise, and fever... 

Erythropoietin products hypertension (monitor blood pressure), thrombosis (e.g., DVT/PE, Ml, CVA, and TIA), arthralgias, and headache... 

Nonspecific complaints include abdominal pain, diarrhea, chest pain, and arthralgia... 

Acyclovir 200 mg PO q4hour x 7-/0 days 400 mg PO 3 times daily x 7-10 days3 200 mg PO q12hour x 7-1 0 days6 Headache, confusion, nausea, vomiting, thrombocytopenia, renal insufficiency, rash, pruritus, fever, arthralgias, myalgia, thrombotic thrombocytopenic purpura, hallucinations, somnolence, depression... 

A 39-year-old male with chronic steroid-dependent asthma who recently relocated to Phoenix, Arizona presents with a 4-week history of increasing fever, dry cough, and pain upon deep inspiration. He also reports arthralgias and night sweats over the last 3 weeks. A chest radiograph reveals a small area of consolidation in the left lower lobe and some hilar adenopathy. Otherwise, all other routine tests and cultures appear negative. 

D/C offending drug if rash worsens to severe (blisters, fever, mucous membrane involvement, conjunctivitis, edema, or arthralgias) or if systemic symptoms are present... 

Anastrozole is a selective nonsteroidal aromatase inhibitor that lowers estrogen levels. The pharmacokinetics of anastrozole demonstrate good absorption, with hepatic metabolism the primary route of elimination and only 10% excreted unchanged by the kidney. The elimination half-life is approximately 50 hours. Anastrozole is used for the adjuvant treatment of postmenopausal women with hormone-positive breast cancer and in breast cancer patients who have had disease progression following tamoxifen. Side effects include hot flashes, arthralgias, osteoporosis/bone fractures, and thrombophlebitis. 

Letrozole is another selective aromatase that inhibits the conversion of androgens to estrogen. Maximum plasma concentrations occur 1 hour after oral dosing concomitant food has not been shown to have an effect on the extent of absorption of letrazole. The terminal half-life is approximately 2 days. Letrozole is used in the treatment of postmenopausal women with hormone-receptor-positive or unknown advanced breast cancer. Side effects include bone pain, hot flushes, back pain, nausea, arthralgia, osteoporosis/bone fractures, and dyspnea. 

Gemcitabine Myelosuppression (especially thrombocytopenia) Flulike syndrome (fever, chills, myalgias, arthralgias), nausea... 

Nonsteroidal Steroidal Anastrozole Letrozole Exemestane 1 mg orally daily 2.5 mg orally daily 25 mg orally daily Hot flashes, arthralgias, myalgias, headaches, diarrhea, mild nausea, osteoporosis (boneloss)... 

---