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Medications For Rheumatoid Arthritis
Notwithstanding that there is no specific treatment for rheumatoid arthritis (RA) thus far, there are variousavailable drugs in the market that are meant to manage its symptoms and ultimately improve the condition.
Overall, rheumatoid arthritis drugs can be grouped into distinct types, as described later in this article. Physicianswill be able to recommend an appropriate medical treatment to alleviate pain and inflammation of the joints, andstop further damage to the joints. Depending on each case, successful treatment can be achieved through acombination of the following options:
NSAIDs or Nonsteroidal Anti-inflammatory Drugs
Nonsteroidal Anti-inflammatory Drugs, commonly known as NSAIDs, work as an anti-inflammatory and in painrelief, but donï¿½t serve to prevent further joint. These medications stop your body from manufacturing asubstance called prostaglandins, which is chiefly responsible for generating pain and inflammation.
Some NSAID examples are naproxen (Naprosyn, Aleve) and ibuprofen (Motrin and Advil). Some more NSAIDsinclude ketoprofen (Orudis), etodolac (Lodine), meloxicam (Mobic), Celecoxib (Celebrex), indomethacin,oxaprozin (Daypro), diclofenac (Cataflam, Voltaren), piroxicam (Feldene), and nabumetone (Relafen).
NSAID medications are frequently recommended when a final diagnosis of rheumatoid arthritis is made. But keepin mind that when consumed in excessive doses for prolonged periods, these medications can produce adverseside effects, like stomach bleeding, gastric ulcers, plus potential damage to the kidney and liver.
One more class of RA medication is corticosteroids. These medications suppress the immune system, ultimatelymanaging inflammation.
Methylprednisolone (SoluMedrol, DepoMedrol), Cortisone (Cortone), betamethasone (Celestone Soluspan),triamcinolone (Aristocort), dexamethasone (Decadron), prednisolone (Delta-Cortef), and prednisone (Deltasoneand Orasone), are examples of corticosteroids.
Even though corticosteroids are successful in rheumatoid arthritis treatment, they have been reported to triggeradverse side effects when taken in extended periods. Examples of these side effects include glaucoma, easybruising, cataracts, excessive weight gain, diabetes, and thinning bones.
Because of the risks of severe side effects, these drugs are generally only used as a short-term solution to controlsudden RA attacks. One major advantage of corticosteroids is that a single injection of the drug will suppressinflammation of a specific joint lasting for a long time.
Disease Modifying Anti-Rheumatic Drugs, a.k.a. DMARDs
Disease Modifying Anti-Rheumatic Drugs (DMARDs) pertain to a class of medications that work to block theimmune system from assaulting the joints, ultimately delaying further progression of joint damage. In rheumatoidarthritis treatment, DMARDs are usually used alongside other meds for greater efficiency.
Rheumatoid arthritis causes permanent joint damage, which starts to manifest at the onset. Accordingly, mostphysicians would recommend DMARD therapy soon after making a diagnosis. You are most responsive toDMARDs during the early stages of RA. The earlier the drug is taken, the more advantageous it is for the patient.
DMARD examples include hydroxychloroquine (Plaquenil), methotrexate (Rheumatrex), cyclosporine(Sandimmune, Neoral), gold salts (Solganal, Myochrysine, Ridaura, Aurolate), penicillamine (Cuprimine),azathioprine (Imuran), cyclophosphamide, minocycline, sulfasalazine (Azulfidine), and leflunomide (Arava).
Though various DMARD brands have produced positive results in treating rheumatoid arthritis, the potential forsevere side effects is large. Taking DMARDs for a long time can set off bone marrow and liver toxicity,susceptibility to infections, skin allergies, and even autoimmunity.
Of the DMARDs previously listed, hydroxychloroquine has the least potential for triggering bone marrow and livertoxicity, and is thus deemed to be one of the safest DMARDs to use. The bad news is that hydroxychloroquine isnot a particularly powerful medication and is not potent enough on its own to treat rheumatoid arthritis symptoms.
Conversely, methotrexate is deemed to be one of the most powerful DMARDs to use in rheumatoid arthritistreatment due to several factors. Methotrexate has been documented to treat RA without causing bone marrowand liver toxicity like other DMARDs. Further, it works effectively and safely when used alongside biologicalagents, another classification of RA drugs discussed below. It is for this reason that methotrexate drugs arefrequently prescribed for use with certain biological agents if the drug does not control rheumatoid arthritis on itsown. But then again, do note while methotrexate is not as potentially unsafe as other DMARDs, it still has theability to hinder the bone marrow or cause hepatitis. In such cases, taking regular blood tests are imperative toguide the individualï¿½s condition, and to cease treatment at the first hint of trouble.
Biological agents, also known as biological drugs, work to lessen inflammation via a range of methods.
An example of how biological agents work is by inhibiting TNFs (tumor necrosis factors). Etanercept (Enbrel),infliximab (Remicade), and adalimumab (Humira) are examples of TNF blockers.
Another method of how biological agents curtail inflammation is through destroying B cells. Rituxan (Rituximab),for example, binds itself to B cells, hence killing them.
Further medications that lessen inflammation through their own way are:
- tocilizumab (Actemra & RoActemra), functions by inhibiting IL-6 or interleukin
- anakinra (Kineret), works by blocking IL-1 or interleukin 1
- abatacept (Orencia), which inhibits T-cells
Remember that every of these biological agents has its own potential for negative side effects. The risks for sideeffects must be considered when prescribing it to any individual.
Salicylates serve to reduce prostaglandins production in the human body. Prostaglandins cause the inflammationand pain of arthritis. In recent times, salicylates have been generally replaced with NSAIDs, mainly due to the factthat salicylates can cause severe side effects, such as potentially causing kidney damage.
Pain Relief Medications
Lastly, a range of pain relief drugs may likewise be used in rheumatoid arthritis treatment. Examples of pain reliefdrugs include tramadol (Ultram) and acetaminophen (Tylenol).
Even though pain relief drugs neither alleviate inflammation nor delay joint damage progression, such drugs allowthe individual to feel more comfortable and eventually function better. For this reason alone, anti-pain drugs aredefinitely worth trying.
Surgery as a Last Resort
If the medications listed above do not produce results, doctors can recommend surgery. Examples of surgicalprocedures meant to treat RA include tendon repair, joint lining removal (i.e. synovectomy), as well as jointreplacement surgery (i.e. arthroplasty), in which the damaged joint is replaced with prosthetics.
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