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Medications For Rheumatoid Arthritis
Although there is no actual treatment for RA or rheumatoid arthritis to this day, there are a range of availablemedications in pharmacies that are meant to relieve its symptoms and ultimately improve the condition.
Overall, medications for rheumatoid arthritis can be grouped into distinctive types, as discussed later in thisarticle. Doctors will design a proper medical treatment to reduce joint inflammation and pain, plus stop furtherdamage to the joints. Depending on each case, effective treatment can be achieved by combining any of thefollowing:
Nonsteroidal Anti-inflammatory Drugs, a.k.a. NSAIDs
Nonsteroidal Anti-inflammatory Drugs, otherwise known as NSAIDs, work in pain relief and anti-inflammation, butdonï¿½t function to prevent further joint. These drugs prevent the body from producing prostaglandins, which ischiefly responsible for generating inflammation and pain.
Some NSAID examples are naproxen (Aleve, Naprosyn) and ibuprofen (Motrin, Advil). Other NSAIDs includeketoprofen (Orudis), meloxicam (Mobic), etodolac (Lodine), Celecoxib (Celebrex), oxaprozin (Daypro),indomethacin diclofenac (Cataflam, Voltaren), nabumetone (Relafen), and piroxicam (Feldene).
NSAID medications are often advised when a definite RA diagnosis is made. But keep in mind that whenconsumed in excessive doses for a long time, these drugs may cause negative side effects, including gastriculcers, stomach bleeding, as well as kidney and liver damage.
A different type of RA medication is corticosteroids. These medications block the immune system, thus lesseninginflammation.
Methylprednisolone (SoluMedrol, DepoMedrol), Cortisone (Cortone), betamethasone (Celestone Soluspan),triamcinolone (Aristocort), prednisolone (Delta-Cortef), dexamethasone (Decadron), and prednisone (Deltasone,Orasone), are examples of corticosteroids.
While corticosteroids may be successful in treating rheumatoid arthritis, they have been said to cause severe sideeffects when taken in extended periods of time. Examples of these side effects include cataracts, glaucoma, easybruising, thinning bones, excessive weight gain, and diabetes.
Given the risks of negative side effects, such drugs are commonly only used as a momentary remedy to managesudden RA attacks. One major advantage of corticosteroids is that a single injection of corticosteroids can inhabitjoint inflammation lasting for a long time.
Disease Modifying Anti-Rheumatic Drugs, a.k.a. DMARDs
DMARDs (Disease Modifying Anti-Rheumatic Drugs) pertain to a classification of drugs that work to block yourimmune system from assaulting the joints, eventually hindering further joint damage progression. When treatingRA, these medications are commonly consumed alongside other meds for more successful results.
RA causes permanent damage to the joints, which becomes apparent in the early stages of the disease. For thisreason, most medical specialists would prescribe DMARDs soon after an RA diagnosis. Individuals are mostresponsive to DMARD treatment during the early stages of RA. The earlier DMARDs are taken, the moreadvantageous it is for the individual.
Examples of DMARDs are cyclosporine (Sandimmune, Neoral), methotrexate (Rheumatrex), hydroxychloroquine(Plaquenil), gold salts (Aurolate, Ridaura, Solganal, Myochrysine), penicillamine (Cuprimine), cyclophosphamide,azathioprine (Imuran), leflunomide (Arava), sulfasalazine (Azulfidine), and minocycline.
Although various DMARD products have produced positive results in treating rheumatoid arthritis, the risks forsevere side effects is large. Using DMARDs for a long time may cause liver and bone marrow toxicity, infections,allergies (particularly of the skin), as well as autoimmunity.
Of the DMARD examples listed above, hydroxychloroquine has the lowest risk of producing liver & bone marrowtoxicity, and is consequently considered to be one of the safest DMARD types. The bad news is thathydroxychloroquine is not a particularly powerful drug and is not potent enough on its own to control RAsymptoms.
In contrast, methotrexate is deemed as one of the most powerful DMARDs to use in treating rheumatoid arthritisbecause of various factors. Methotrexate has been known to effectively fight RA without affecting the toxicity ofthe bone marrow and liver like most other DMARDs. Additionally, methotrexate has been proven safe andeffective when used together with biological agents, which are another group of RA drugs to be discussed later.
Consequently, it is commonly recommended together with certain biological agents in cases where the drug doesnot adequately treat rheumatoid arthritis on its own. Then again, it should be noted that while methotrexate is notas potentially dangerous as others, it still has the ability to obstruct the bone marrow or cause hepatitis. If thishappens, taking regular blood tests are advised to guide oneï¿½s condition, as well as to cease treatment at thefirst sign of complications.
Biological drugs or biological agents work to alleviate inflammation through a variety of ways.
One example of how biological drugs work is by inhibiting TNFs (tumor necrosis factors). Infliximab (Remicade),etanercept (Enbrel), and adalimumab (Humira) are common TNF blockers.
Another way with which biological agents manage inflammation is through killing B cells. The Rituxan (Rituximab)drug, for instance, unites with B cells, thus killing them.
Further medications that lessen inflammation in their own distinctive ways are:
- tocilizumab (e.g. Actemra and RoActemra), inhibits interleukin (IL-6)
- anakinra (e.g. Kineret), which works by blocking IL-1/interleukin 1
- abatacept (i.e. Orencia), which blocks T-cells
You should consider that every biological agent has its own risks for negative side effects. The risks for sideeffects must be considered when recommending it to a patient.
Salicylates work by reducing prostaglandins production. Prostaglandins produce the pain and inflammation ofarthritis. In recent times, salicylates have been widely replaced with nonsteroidal anti-inflammatory drugs, mainlysince the former cause serious side effects, including damaging the kidney.
Pain Relief Medications
Last but not least, a variety of pain relief drugs can also be taken in rheumatoid arthritis treatment. Examples ofpain relief medications include tramadol (Ultram) and acetaminophen (Tylenol).
While pain relief medications neither alleviate inflammation nor delay further joint damage, these medicationsallow the individual become more comfortable and in due course function better. Hence, anti-pain medications arecertainly worth mentioning.
Surgery as a Last Resort
If the medications listed above fail to produce results, your doctor may probably recommend surgical treatment.
Surgical procedures used in rheumatoid arthritis treatment are tendon repair, joint lining removal (i.e.
synovectomy), as well as arthroplasty (joint replacement surgery), in which the damaged areas of the joint arereplaced with prosthetics.
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