by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
Click here: Second Opinion Arthritis Treatment Kit
Drugs used for arthritis have four major purposes. The first is to reduce pain and inflammation; the second is to improve quality of life; the third is to slow down disease progression; the fourth is to induce remission, if possible.
There are four major classifications of drugs used to treat arthritis. They are:
Analgesics. These drugs block pain without reducing inflammation. They fall into non-narcotic and narcotic categories. Obviously the narcotic category is reserved for patients with very severe pain unresponsive to lesser analgesics. Non-narcotic analgesics are drugs like acetaminophen. Narcotic analgesics are medicines like Vicodin, Percocet, etc. A drug that falls midway between is tramadol which has minimal to mild narcotic properties.
Anti-inflammatory drugs. Also known as NSAIDS (non-steroidal anti-inflammatory drugs), these drugs block inflammation and secondarily reduce pain. Most of these drugs work by blocking an enzyme called cyclooxygenase (COX). Since cyclooxygenase comes in at least two varieties (COX 1 and COX 2), the question is which cyclooxygenase do NSAIDS block? The answer for most of the older NSAIDS is both of them... which is why the older NSAIDS have both anti-inflammatory effects as well as less desirable side effects such as stomach ulcers, reduced kidney function, and so on.
COX 2 inhibitors block only COX 2 which allows them to block inflammation without leading to the increased incidence of ulcers seen with the older drugs. Unfortunately, COX 2 inhibitors, like all other NSAIDS lead to an increased incidence of cardiovascular events (heart attacks and strokes) in susceptible patients.
Disease-modifying drugs. These drugs act on the underlying arthritis process and by selectively blocking certain immune targets, can actually slow the process of destructive change down. Examples are drugs like methotrexate, leflunomide, azathioprine, sulfasalazine, cyclosporine, and hydroxychloroquine. Older DMARDS such as gold and penicillamine are rarely used any more.
Newer DMARDS known as biologics are probably even more effective. However, these drugs, by suppressing the immune response, also leave the patient open to more serious infectious complications.
While DMARDS are effective for inflammatory forms of arthritis, very few DMARDS exist for the most common form of arthritis, osteoarthritis. Fortunately, new research into the use of autologous (a patient's own) mesenchymal stem cells is promising.
Biologic drugs are the latest addition to our arsenal of arthritis treatments. If DMARDS are viewed as a shotgun, biologics can be look at as laser beams that target specific immunologic targets in diseases such as rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.
Get more information about arthritis drugs as well as...
• Insider arthritis tips that help you erase the pain and fatigue of rheumatoid arthritis almost overnight!
• Devastating ammunition against low back pain... discover 9 secrets!
• Ignored remedies that eliminate fibromyalgia symptoms quickly!
• Obsolete treatments for knee osteoarthritis that still are used... and may still work for you!
• The stiff penalties you face if you ignore this type of hip pain...
• 7 easy-to-implement neck pain remedies that work like a charm!
• And much more...
Click here Second Opinion Arthritis Treatment Kit
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