DISEASE-WISE
USE OF DRUGS
A.
Rheumatoid Arthritis
The
choice of drugs depends upon the condition of the patient and severity of
the disease. However, as the
first line of treatment, NSAIDs such as aspirin are used.
Due to gastrointestinal effects of NSAIDs, a newer type of NSAID
like celecoxib or rofecoxib can be used.
In severe cases, other drugs such as corticosteroid or DMARDs may
be used. Drugs that suppress
the immune system, like azathioprine and cyclosporine, may be used in
people who have failed other therapies.
Associated with toxic side-effects, these medications are reserved
for severe cases of rheumatoid Arthritis.
B.
Osteoarthritis
NSAIDs
are usually given in the short-term to produce symptomatic relief. Several
new NSAIDs such as COX-2 inhibitors ( celecoxib, rofecoxib, valdecoxib)
are now being used to treat osteoarthritis.
These medicines reduce inflammation similar to traditional NSAIDs,
but cause fewer gastrointestinal side-effects.
Paracetamol is also effective and has fewer side-effects than other
NSAIDs. Glucosamine and
chondratin sulphate have shown to relieve symptoms of pain and stiffness
for some persons with osteoarthritis.
Hyaluronic
acid is a newer medication for joint injection, used to treat
osteoarthritis of the knee. This substance is a normal component of the
joint, involved in joint lubrication and nutrition.
C.
Ankylosing Spondylitis
NSAIDs
are generally used to provide relief from pain. Among NSAIDs, indomethacin
has been used traditionally.
D.
Gout
The
treatment is initiated as per the condition of the patient.
Generally, NSAIDs are used to control pain and provide relief.
Corticosteroid drugs may be injected directly into the affected
joint. If NSAIDs do not
control symptoms, the doctor may prescribe colchicines. This is most effective when given within 12 hours after an
acute attack begins. It
attacks continue to occur even with these medications and lifestyle
changes, a drug to reduce the body’s production of uric acid, most
commonly allopurinol or probenecid, may be prescribed. Some
individuals will be overproducing uric acid, while others will be failing
to eliminate enough uric acid. Different types of medications are used in each instance.
Medications commonly used to treat inadequate elimination of uric
acid include probenecid. For
those who overproduce uric acid, treatment is allopurinol.
Uricosurics,
like probenecid, are used to prevent gout attacks in patients who are
found not be at risk from kidney stones.
Because of their relative safety, uricosuric drugs are good choices for
patients with recurrent gouty attacks despite colchicine prophylaxis in patients who have normal kidney function.
Probenecid prevents reabsorption of uric acid by the kidney and leads to
more excretion of uric acid. Allopurinol
is used when you have already had several gout attacks that are not
responding well to colchicines, when you have hyperuricemia with kidney
stones associated with your gout, when
uricosurics have failed to maintain appropriate serum urate levels,
when you are allergic or intolerant to uricosuric agents, when you have
tophaceous gout, or as prophylaxis against kidney damage from uric acid
crystals in patients on cancer chemotherapy.
If allopurinol is prescribed for you, take it regularly, even if
you are taking another medicine for attacks.
It is a long-term medication, and suddenly stopping and starting
this medication can also trigger gouty attacks.
E.
Lumbago
NSAIDs
are used to provide relief from pain.
F.
Cervical Spondylitis
Paracetamol
is the first line drug. It is considered as effective as NSAIDs.
It has fewer side-effects than NSAIDs.
In many cases, aspirin or other NSAIDs are also used, depending
upon the patient’s response to therapy.
In severe conditions, injections or corticosteroid can be given.
But it should not be used for long-term management.
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