Patient Encounter 1 Part 2 Medical History Physical Examination and Diagnostic Tests

PMH: Asthma, well controlled with current medication regimen; allergic rhinitis

SH: Denies smoking; drinks alcoholic beverages on most days

Meds: Fluticasone 220 mcg one puff twice daily; albuterol (salbutamol) two to four puffs 4 times daily as needed

Allergies: Aspirin (difficulty breathing)

Diagnostic Tests: Radiographs of left ankle show no evidence of fracture What are your treatment goals and desired outcomes?

What nonpharmacologic and pharmacologic treatments options are available? Are there treatment options that should be avoided? If so, which options and why?

Muscle Relaxants

Where pain is worsened by muscle spasm, oral muscle relaxants serve as a useful adjunct to therapy.51 These agents include baclofen, metaxalone, methocarbamol, carisoprodol, and cyclobenzaprine. Muscle relaxants decrease spasm and stiffness associated with either acute or chronic musculoskeletal disorders. These agents should be used with caution because they all may cause sedation, especially in combination with alcohol or narcotic analgesics.

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