Medication-induced adverse effects: important concepts for the hand therapist.

UNLABELLED: NARRATIVE REVIEW: Myopathy, fracture, tendon rupture, and neuropathy are severe physical adverse effects associated with commonly prescribed medications. Recognition of and exercise adjustment for these medication-induced effects by the therapist is essential to providing adequate care. The normal structure and function of muscle, tendon, cartilage, or bone may be altered by medications, leading to significant disability. The number of patients presenting to therapists with medication-induced physical complaints is rising with increases in medication utilization. Therapists should be involved in adverse effect risk reduction by 1) identification and reporting of potential adverse medication reactions, 2) adjustment of exercise regimen when the patient is on a medication with potential damaging effects on tendon, muscle, or cartilage, and 3) vigilant screening for medication-induced myopathies, fractures, neuropathies, and tendinopathies. Although many medications induce physical adverse effects, understanding the most serious musculoskeletal effects of commonly prescribed medications is critical for therapists. LEVEL OF EVIDENCE: 5. Copyright 2010 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.