A 68-year-old female patient with senile osteoporosis and rheumatoid arthritis returns to the office for her first Reclast infusion. The physician reviews the patient’s past lab results. The patient reports she still has pain, stiffness, and swelling in her left elbow, wrists, and lower back. Her pain is at a level of 8 out of 10 for severity. She denies any fevers, cough, or dyspnea. She currently is on a nonsteroidal antiinflammatory drug, weekly methotrexate injections, and folic acid. The physician performs an expanded problem-focused exam. The physician decides to add celecoxib to address the pain in her joints. Her past medical information reveals that last year she had a fracture of her left wrist from falling in her kitchen. The patient then receives IV Reclast 5-mg infusion over 20 minutes.
