Narcotic pain relievers help with pain but don’t relieve joint inflammation. Often they are combined with Tylenol (acetaminophen) or an NSAID to enhance their effects. You can develop dependency on narcotic drugs, and they can cause constipation, urinary problems, and sedation.
There are several versions of hyaluronan injections — also called viscosupplementation — that are used to treat osteoarthritis of the knee. They are injected directly into the joint. They can help reduce the pain in a knee affected by osteoarthritis, increasing mobility and allowing more activity.
All corticosteroids slow bone growth and create conditions that lead to osteoporosis, a disease process that results in reduction of bone mass. Compression fractures of the vertebrae can happen with long-term corticosteroid use. Men and women past menopause are most likely to develop osteoporosis. Your doctor may recommend that you take calcium and vitamin D pills while you take corticosteroids.
Chemotherapy, traditionally used as cancer treatment, helps people with certain inflammatory and autoimmune diseases because it slows cell reproduction and decreases certain products made by these cells that cause an inflammatory response to occur. The doses of medication used for rheumatic or autoimmune conditions are lower than the doses used for cancer treatment.
Anti-Inflammatory Painkillers (NSAIDs)
These drugs, both over-the-counter and prescription can be used to relieve the symptoms of arthritis (joint swelling, stiffness, and pain). Almost everyone with arthritis has taken or is taking one of these drugs.
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.
The tried-and-true anti-inflammatory medications can relieve pain, improve daily function, reduce joint swelling and tenderness, and improve range of motion — and that’s all good. “All my patients take these drugs,” Kavanaugh says.
But there’s so much more. In the past two decades, drugs that target the immune system have become a backbone of treatment. A class of drugs called disease-modifying antirheumatic drugs (DMARDs) is able to alter the course of rheumatoid arthritis by suppressing or interfering with the immune activity that attacks joints.
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, weight loss, neuropathy and vasculitis (blood vessel inflammation
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.
By: Peter sams
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