Fluoroquinolone-Induced Arthralgia and Myalgia in the Treatment of Sinusitis

Abstract

Although effective and generally well tolerated in the treatment of sinusitis, fluoroquinolone antibiotics may produce adverse effects of arthralgia and/or myalgia.

Effect of pharmacist-led patient education on adherence to tuberculosis treatment

“…A pharmacist aware of the patient's clinical status should be ready to recommend an appropriate replacement therapy in the form of iron (where deficiency is confirmed), vitamin A, zinc replacement, or special oral feeding formulations. 42,46 Glycemic control was another need encountered in 11.4% of the first-time TB patients and 27.5% of the MDR-TB patients. Several of these individuals continued to receive sulfonylureas, which can potentially interact with rifampin, 47 resulting in a decrease in the effectiveness of the antidiabetic medications and potentially leading to hyperglycemia.…”

“…40 Drug-related metabolic issues encountered in this study were hyperuricemia, which is frequently linked to pyrazinamide administration, 34 and elevated transaminase levels, which can be triggered by any of the components of the standard combination. 34,42 The most common interaction for MDR-TB patients was between quinolones and antacids used to allay GI adverse effects or with nutrient replacement preparations containing minerals. Metal cations (e.g., iron, aluminum, zinc) are known to bind up to 98% of quinolones in the GI tract, and therefore such preparations should be administered at least four hours before the quinolone dose.…”

“…Increasing the dose gradually can help to improve tolerability. 42,34 If antacids are resorted to, care must be taken not to coadminister them with isoniazid since the latter's absorption from the GI tract can be signifi cantly reduced by antacids. 40 The most common problem in the MDR-TB group, affecting 75% of the patients, was related to sensory functions, particularly hearing, touch, and sight.…”

Medikamenteninduzierte Myopathien

“…Antihistaminika wie Diphenylhydramin verursachen häufig Rhabdomyolysen [96]. Chinolone führen in 25 der Fälle zu Myalgien [97]. Unter Quinupristin-Dalfopristin können ebenfalls Myalgien auftreten, vor allem wenn gleichzeitig eine Leberfunktionsstörung besteht bzw.…”

Fluoroquinolone use in a child associated with development of osteochondritis dissecans

“…While the Achilles tendon is commonly involved, adverse effects in several other tendons have been reported 21 22. Arthralgia and myalgia also occur at a higher incidence in patients taking fluoroquinolones 19 23 24. Studies examining the association between fluoroquinolones and arthropathy in children by MRI have identified cartilage abnormalities 24.…”