pr20
Forum Senior
Topics: 20
Posts: 168
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A 41-year old woman presents with chronic widespread musculoskeletal pain,fatigue,and frequent headaches.She states that her musculoskeletal pain improves slightly with exercise.On examination,painful trigger points are produced by palpation of the trapezius and lateral epicondyle of the elbow.Objective signs of inflammation are absent,and laboratory studies are normal.This patient would most likely experience which of the following medication-related side effects after the most appropriate treatment measure is instituted?
A.Adrenal suppression
B.Decreased renal blood flow
C.Anticholinergic effects
D.Decreased respiratory rate
E.Serum-like sickness
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| docdoc9
Forum Elite
Topics: 28
Posts: 221
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painful trigger points.......polymyalgia rheumatica(temporal arteritis).......prednisone is given to prevent blindness........therefore adrenal suppression
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| Tiff
Forum Guru
Topics: 54
Posts: 563
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Isn't she a little young for temporal arteritis?
I was thinking fibromyalgia treated with antidepressants like TCA which have anticholinergic effects. Choice C
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| jean robert
Forum Guru
Topics: 162
Posts: 669
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C
___________________
Great works are performed not by strength, but by perseverance.
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| jerker
Forum Newbie
Topics: 0
Posts: 12
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yeah its A:
adrenal supression.
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| seem.bh
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its c
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| pr20
Forum Senior
Topics: 20
Posts: 168
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Answer is C.
The pt is presenting with signs and symptoms of fibrositis (fibromyalgia).This disorder is most commonly seen in women between the ages of 20 and 50 and is associated with widespread chronic musculoskelatal pain (that improves with exercise), chronic fatigue,and sometimes severe headaches.Examination typically reveals painful trigger points produced by palpation of the trapezius and the lateral epicondyle of the elbow.Objective signs of inflammation are absent and laboratory tests are normal.Patients with this disorder are likely to respond to treatment with tricyclic antidepressants or skeletal muscle relaxants with strong anticholinergic side effects,such as cyclobenzaprine.One of the most effective agents in the treatment of this disorder is amitryptiline,a tricyclic antidepressant which is associated with the development of strong anticholinergic side effects,such as dry mouth,tachycardia,urinary retention,and decreased gastrointestinal mobility.
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