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What rheumatoid arthritis medications are available?
Nonsteroidal anti-inflammatory drugs (NSAIDs), which includes aspirin, helps relieve both pain and inflammation if you take the drugs regularly. NSAIDs This group of drugs does not include corticosteroids (cortisone and other related substances). Like aspirin, these medications can relieve some of the signs of inflammation and some of the pain associated with rheumatoid arthritis. A side effect of these drugs can be bleeding from the stomach, although this does not occur as often as
with plain aspirin. Sometimes people require additional medications to prevent the side effects of NSAIDs on the stomach. The various NSAIDs and aspirin, if taken in full doses, usually have the same levels of anti-inflammatory effect. However, different individuals may experience greater relief from one medication than another. Because aspirin has similar effects and side effects, one should not ordinarily take aspirin while taking a nonsteroidal anti-inflammatory drug. If you have any questions, it is best to check with your care provider.
Injectable gold salts (Myochrysine, Solganal) have been used in rheumatoid arthritis for more than 60 years. As experience was gained with this type of medication, physicians were able to establish doses that are both reasonably effective and acceptably safe. Gold is a remittive agent that can prevent disease progression. It is generally given by injection but can be taken orally. It has some common toxicities including skin and mucous membrane problems. About 1% of patients get kidney or blood problems related to gold injections and/or oral ingestion. Careful monitoring of gold therapy is very important in patients with rheumatoid arthritis. During the duration of the therapy complete blood counts, platelet counts and urinalyses must be done at the time of each injection. After a prolonged period of time without toxicity monitoring may be done every other injection. If severe blood reactions and/or kidney problems develop then medication should be discontinued.
Plaquenil or hydroxychloroquine is an anti-malarial agent with anti-inflammatory properties in rheumatoid arthritis. Like gold it is used in those patients who fail to respond to a conservative regimen including rest, salicylates and/or other nonsteroidal anti- inflammatory drugs. These are given orally. Ophthalmologic monitoring is necessary to check for visual loss at an early reversible stage. Patients should be seen by their eye doctors a minimum of once a year. This therapy should be discontinued if any eye problems are related to the medication. Possible side effects include upset stomach, skin rashes, muscle weakness, and vision changes. Even though vision changes are rare, patients taking Plaquenil should be monitored by an eye doctor (ophthalmologist).
Penicillamine has been shown in controlled studies to be effective in reducing inflammatory arthritis such as rheumatoid arthritis. It is given orally. Like gold it may be associated with a variety of problems including skin and mucous membrane problems, blood disorders and/or kidney problems. It must be carefully monitored. Complete blood counts, platelet counts and urinalyses should be done monthly for the first six months of therapy and every other month thereafter. Laboratory data is essential to permit early detection of problems with the blood and/or kidneys. Side effects are similar to those of gold. They include fever, chills, mouth sores, a metallic taste in the mouth, skin rash, kidney and bone marrow damage, stomach upset, and easy bruising. Patients on this medication require routine blood and urine tests. D-penicillamine can rarely cause symptoms of other autoimmune diseases.
Corticosteroids are among the most potent of the anti-inflammatory agents. However they have a high incidence of toxicity and may not change the course of rheumatoid arthritis. They should only be used in patients with activie synovitis in many joints. These medications are useful in incapacitating constitutional symptoms such as fever, anemia, wieght loss, neuropathy and vasculitis (blood vessel inflammation). Side effects may include easy bruising, thinning of bones, cataracts, weight gain, a round face and diabetes. Doctors often prescribe a corticosteroid to relieve acute symptoms, with the goal of gradually tapering off the medication.
Sulfasalazine (Azulfidine) is an oral medication traditionally used in the treatment of mild to moderately severe inflammatory bowel diseases, such as ulcerative colitis and Crohn's colitis. Azulfidine is used to treat rheumatoid arthritis in combination with antiinflammatory medications. Azulfidine is generally well tolerated. Sulfasalazine (Azulfidine) is a drug useful in the treatment of both rheumatoid arthritis and inflammatory diseases of the bowel. It is generally taken twice daily ina dose of 2 grams total per day. Common side effects include rash and upset stomach. Because Azulfidine is made up of sulfa and salicylate compounds, it should be avoided by patients with known sulfa allergies.
Methotrexate is a new usage of a very old medication. In general it is given by "modified pulse" with 3 to 9 tablets administered weekly. Methotrexate should only be given by those physicians who are knowledgeable and experienced in its usage. The use of Methotrexate involves periodic monitoring for toxicity. Monitoring should include complete blood counts with differential and platelet counts. It should also involve liver and renal function tests. Patients who are at increased risk for impaired Methotrexate elimination (i.e., patients with kidney problems) should be monitored more frequently. Methotrexate may be associated with a variety of problems including liver toxicity, lung problems, mouth ulcers, stomach pain, etc. Liver biopsies may be necessary if there is a question about the degree of Methotrexate liver toxicity and continuation of this drug.
Prednisone is the preferred agent because of its cost and low potential for fluid retention. Tablets are available in 1 mg and 5 mg dosages. All patients should be educated about the side effects of corticosteroids. Informed consent is most inportant in their use.
More information on rheumatoid arthritis and other arthritis conditions (osteoarthritis, septic arthritis, psoriatic arthritis, Reiter's syndrome, ankylosing spondylitis, gout)
What is rheumatoid arthritis? - Rheumatoid arthritis (RA) is an autoimmune disorder that marked by stiffness and inflammation of the joints, weakness, loss of mobility, and deformity.
What causes rheumatoid arthritis? - The cause of rheumatoid arthritis (RA) is unknown. Rheumatoid arthritis involves an attack on the body by its own immune cells (auto-immune disease).
What're the symptoms of rheumatoid arthritis? - The symptoms that distinguish rheumatoid arthritis are inflammation and soft-tissue swelling of many joints at the same time (polyarthritis).
How is rheumatoid arthritis diagnosed? - Health professionals diagnose rheumatoid arthritis by examining joints and evaluating ymptoms, medical history, and results of several tests.
What's the treatment for rheumatoid arthritis? - The treatment of rheumatoid arthritis includes the use of non-drug treatment such as rest and physiotherapy, drugs may be required both to control symptoms of the disease.
What rheumatoid arthritis medications are available? - Rheumatoid arthritis medications include nonsteroidal anti-inflammatory drugs, injectable gold salts, plaquenil or hydroxychloroquine.
What rheumatoid arthritis diet is suggested? - Certain vitamin supplements may be beneficial. Many herbs also are useful in the treatment of rheumatoid arthritis.
What is juvenile rheumatoid arthritis? - Juvenile rheumatoid arthritis (JRA) is a form of arthritis in children ages 16 or younger that causes inflammation and stiffness of joints for more than six weeks.
What causes juvenile rheumatoid arthritis? - Juvenile rheumatoid arthritis is an autoimmune disorder. Juvenile rheumatoid arthritis is considered to be a multifactorial condition.
What're the symptoms of juvenile rheumatoid arthritis? - Symptoms of juvenile rheumatoid arthritis may appear during episodes (flare-ups) or may be chronic and continuous.
How is juvenile rheumatoid arthritis diagnosed? - Diagnosis of juvenile rheumatoid arthritis is often made on the basis of the child's collection of symptoms.
What're the treatments for juvenile rheumatoid arthritis? - The treatment of juvenile rheumatoid arthritis centers on decreasing joint inflammation, suppressing pain, and preserving movement.
What is osteoarthritis? - Osteoarthritis (OA), also known as arthrosis or degenerative joint disease, is a disease featuring pain and impaired function of the joints.
What causes osteoarthritis? - Primary osteoarthritis is mostly related to aging. Osteoarthritis results from a combination of genetic predisposition and joint injuries.
What're the risk factors for osteoarthritis? - Risk factors for osteoarthritis are congenital hip luxation, obesity, osteoporosis, and inflammatory diseases.
What're the complications of osteoarthritis? - The major complication of osteoarthritis is pain. The degree of pain can vary greatly. Osteoarthritis itself is not life threatening.
What are symptoms of osteoarthritis? - The main symptoms of osteoarthritis are is pain that worsens during activity and that gets better during rest.
How is osteoarthritis diagnosed? - The doctor makes the diagnosis of osteoarthritis based on the characteristic symptoms, physical examination, and the x-ray appearance of joints.
What's the treatment for osteoarthritis? - Osteoarthritis is treated with nonsteroidal anti-inflammatory drugs. Severe pain in specific joints can be treated with local injections with lidocaine.
What're the medications for osteoarthritis? - Acetaminophen is used for mild to moderate osteoarthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs) or COX-2 medications for moderate to severe arthritic pain.
What nutritional supplements cure osteoarthritis? - A combination of glucosamine and chondroitin sulfate is used as a dietary supplement to cure osteoarthritis. Vitamin D and calcium are recommended for strong bones.
Treatments for osteoarthritis pain relief - OTC pain relievers like acetaminophen (Tylenol) and aspirin are familiar choices for the treatment of osteoarthritis pain relief.
What osteoarthritis exercise is suggested? - Regular exercise is very important for successful control of osteoarthritis. Exercise helps patients ostearthritis in the hip or in the knee.
Can osteoarthritis be prevented? - Obese people are at risk of osteoarthritis and that weight loss can help prevent or delay osteoarthritis from occurring.
What is osteoarthritis of the hip? - Osteoarthritis of the hip can cause insidious pain in the groin or inguinal region and, on occasion, pain in the side of the buttock or upper thigh.
What is arthritis? - Arthritis is a group of conditions that affect the health of the bone joints in the body. Arthritis is painful inflammation of a joint or joints of the body.
What types of arthritis are there? - Types of arthritis include osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, gout, infectious arthritis, fibromyalgia, lupus.
What causes arthritis? - The causes of arthritis depend on the form of arthritis. The cause of arthritis may be an infection, injury, abnormality of the immune system, aging.
What're the risk factors for arthritis? - Risk factors for arthritis include age, gender, obesity, injury, ethnicity. The risk of developing arthritis increases with age.
What're the signs and symptoms of arthritis? - Different types of arthritis have different symptoms. Other arthritis symptoms include fatigue, fever, a rash and the signs of joint inflammation.
How is arthritis diagnosed? - The diagnosis of arthritis is based on the pattern of symptoms, medical history, family history, physical examination, X-rays and lab tests.
What's the treatment for arthritis? - The objectives in the treatment of arthritis are controlling inflammation, preserving joint function, and curing the disease if that is possible.
Therapies for arthritis pain relief - Short-term relief for arthritis pain and inflammation may include pain relievers. NSAIDs are used to reduce pain and inflammation.
What natural therapies are available to cure arthritis? - Natural therapies for arthritis pain relief include glucosamine, chondroitin sulfates, nettle leaf, S-adenosylmethionine, and exrutine.
What can be done to prevent arthritis? - Consumption of green tea may prevent arthritis damage and benefit the arthritis patient by reducing inflammation and slowing cartilage breakdown.
What is the Arthritis Foundation? - The Arthritis Foundation is the only nationwide, nonprofit health organization helping take greater control of arthritis in the United States.
What is septic arthritis (infectious arthritis)? - Septic arthritis, also known as infectious arthritis or pyogenic arthritis, is an infection in the joint (synovial) fluid and joint tissues.
What causes septic arthritis? - Septic arthritis develops when bacteria spread from a source of infection through the bloodstream to a joint or the joint is directly infected by traumatic penetration.
What're the symptoms of septic arthritis? - The symptoms of septic arthritis (infectious arthritis) include swelling in the infected joint and pain when the joint is moved.
How is septic arthritis diagnosed? - The diagnosis of infectious arthritis depends on a combination of laboratory testing with careful history-taking and physical examination of the affected joint.
What is the treatment for septic arthritis? - The goal of treatment for septic arthritis is to eliminate the infection with antibiotic therapy. Septic arthritis requires immediate treatment.
What is psoriatic arthritis? - Psoriatic arthritis is a chronic inflammation of the joints that occurs in some people with a chronic skin and nail condition known as psoriasis.
What causes psoriatic arthritis? - The cause of psoriatic arthritis is unknown. Psoriatic is triggered by an attack of the body's own immune system on itself.
What're the symptoms of psoriatic arthritis? - Symptoms of psoriatic arthritis include dry, scaly, silver patches of skin combined with joint pain and destructive changes in the feet, hands, knees, and spine
How is psoriatic arthritis diagnosed? - The diagnosis of psoriatic arthritis is made by identifying the typical symptoms of arthritis in a person with psoriasis.
What's the treatment for psoriatic arthritis? - Treatment of psoriatic arthritis focuses on controlling the skin rash and relieving joint inflammation.
What is Reiter's syndrome (reactive arthritis)? - Reiter's syndrome (reactive arthritis) is a group of symptoms consisting of arthritis, urethritis, conjunctivitis, and lesions of the skin.
What causes Reiter's syndrome (reactive arthritis)? - Reiter's syndrome appears to be a reaction to an infection that begins in an area of the body other than the joints.
What're the symptoms of Reiter's syndrome? - The symptoms of of Reiter's syndrome appear within days or weeks of infection followed by a low-grade fever, conjunctivitis.
How is Reiter's syndrome diagnosed? - Diagnosis of Reiter's syndrome is often difficult because there is no specific test to confirm that a person has reactive arthritis.
What's the treatment for Reiter's syndrome? - The objective of treatment for Reiter's syndrome is to alleviate the symptoms associated with the syndrome and to treat any underlying infection.
What is ankylosing spondylitis? - Ankylosing spondylitis is a chronic inflammatory disease that affects the joints between the vertebrae of the spine, and the joints between the spine and the pelvis.
What causes ankylosing spondylitis? - The specific cause of ankylosing spondylitis is unknown, but the disease tends to run in families, indicating that genetics plays a role.
What're the symptoms of ankylosing spondylitis? - Symptoms of ankylosing spondylitis include back pain, loss of appetite, weight loss, fatigue, and anemia.
How is ankylosing spondylitis diagnosed? - Doctors usually diagnose ankylosing spondylitis simply by the patient's report of pain and stiffness.
What's the treatment for ankylosing spondylitis? - Physical therapy for ankylosing spondylitis can provide a number of benefits, from pain relief to improved physical strength and flexibility.
What is gout (gouty arthritis)? - Gout or gouty arthritis is a form of arthritis caused by the accumulation of uric acid crystals (due to hyperuricemia) in joints.
What causes gout (gouty arthritis)? - Gout is caused by a defect in metabolism which results in an overproduction of uric acid or leads to reduced ability of the kidney to eliminate uric acid.
What are the risk factors for gout? - Risk factors for gout (gouty arthritis) include genetics, age, gender, alcohol use, obesity, medications, and medical conditions.
What're the complications of gout? - Gout often accompanies heart problems, including high blood pressure, coronary artery disease, and congestive heart failure.
What are the symptoms of gout (gouty arthritis)? - An attack of chronic gout is similar to an attack of acute gouty arthritis. The affected joints show signs of warmth, redness, and tenderness.
How is gout diagnosed? - The diagnosis of gout is generally made on a clinical basis. Physicians can diagnose gout based on the physical examination and medical history.
What's the treatment for gout (gouty arthritis)? - The goals of treatment for gout consist of alleviating pain, avoiding severe attacks in the future, and preventing long-term joint damage.
What gout medications are available? - Gout medications include nonsteroidal anti-inflammatory drugs, colchicine, corticosteroids, xanthine oxidase inhibitors, uricosuric agents.
What gout diet is suggested? - The principle of a gout diet is to reduce purines or lower uric acid when we take food. Avoid foods high in purines. Alcohol should be avoided.
How to prevent gout (gouty arthritis)? - Prevention is the best defense against gout (gouty arthritis). Losing weight and limiting alcohol intake can help ward off gout.