10 Medications and allergies Any use of anticoagulants or potent antiplatelet therapy or other drugs that may promote GI injury/ blood loss, e.g., SSRIs, bisphosphonates? Any potent CYP3A4 or P-glycoprotein inhibitors? (See “Management of Acute Pericarditis” on page 16.) Pregnancy (gestation) and breastfeeding? Any known drug allergies or relevant food/excipient allergies? Any history of adverse drug reactions to NSAIDs/ colchicine/steroids or exposure to drugs that can trigger systemic lupus erythematosus (SLE) (e.g., hydralazine, procainamide, TNFa-inhibitors)? Social history Occupational history (impact on job, financial resilience, capacity to abstain from manual work/ physical exertion, occupational injury)? Travel history, including travel to countries with high TB prevalence (Africa, S/SE Asia, China and India) or exposure to pathogens, ability to transport/store medication? Smoking history? Encourage smoking cessation, which will also reduce risks of GI ulceration with NSAIDs/steroids. Alcohol history: (relevant to reducing risks of GI upset/ ulceration and, where excessive, hepatic dysfunction, which may impact drug metabolism)? Recreational drug misuse or chronic opioid use/chronic pain/addiction? Factors that may impact care: e.g., pets, caring responsibilities, impact of illness on relationships, family, finances? Family history Any family history of autoimmune rheumatic disease, inflammatory bowel disease, periodic fever syndromes/ autoinflammatory disease. Any family history of TB or TB exposure? Review of systems General Any unexplained malaise/fatigue, anorexia, weight loss, fever/rigors, night sweats, lymphadenopathy, polyuria, polydipsia, insomnia, hypersomnolence. Respiratory Pleuritic chest pain, shortness of breath, cough, sputum, hemoptysis, wheeze. Abdominal Dysphagia, reflux, peritonitic abdominal pain (especially if recurrent), diarrhea, constipation, change in bowel habit, GI bleeding, hematemesis. Neurologic Headache, visual disturbance/diplopia, red eye/ discharge, muscle pain, paresthesia/sensory disturbance, neuropsychiatric disturbance. Musculoskeletal/Rheumatologic/Skin Arthritis (arthralgia, swelling, erythema, pattern of involvement), enthesitis, alopecia, dry eyes/ mouth, photosensitive rash, erysipelas-like rash, conjunctivitis, temperature-related rash, oral/ genital ulceration, Raynaud’s, digital ulceration.
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