Types of medicines for arthritis
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
Information, in part, from the Arthritis Foundation
There are many different kinds of arthritis medicines available.
The type of arthritis condition will generally dictate what type of medicines is used.
Generally, two broad categories of medicines are employed. The first type is the anti-inflammatory drug. These drugs will help with symptoms but will not have an effect on the disease process itself.
The second group is the disease-modifying type of medicines. These medicines will help alter the course of disease, slowing down progression, but will not necessarily help with symptoms immediately.
There is actually a third group, called biologics. These are targeted immunosuppressive therapies that are used primarily in autoimmune forms of arthritis.
It is important to know what type of arthritis it is you’re dealing with and what the physician’s plans are for you.
I'll cover arthritis medicines in detail (below) but first here is some very important advice.
Know these general principles about every drug you take:
• What- Know both the generic and trade names of your medications
• Why- Know why you are taking it and what it can do for you
• How-Know how to take it correctly
• Adverse effects: be familiar with the common side effects
• Take your medicine exactly as your physician prescribed it. Never change your dosage on your own.
• Take all arthritis medicines with food unless directed otherwise. Use the sandwich technique
1. Eat a little food
2. Take your medication
3. Eat a little more food
• Keep each medication in a labeled container
• Give your medications time to work. Find out from the physician how long each drug will probably take to show results.
• Keep your medication out of the reach of children. Ask the pharmacist for non child proof containers if you have problems opening your medication containers.
• Always bring your medications with you when you have an appointment with the physician. Have them near the telephone if you call the physician about your condition.
• Report possible side effects or unusual reactions such as rash, fever, nausea, vomiting, headaches to your physician.
• Always tell your physician about any other drugs or supplements you are taking whether they are over the counter or drugs prescribed by another physician. This is important because of harmful reactions between certain medications.
• Be honest with your doctor. If you have not been taking your medication as prescribed, tell him or her the truth.
• Don’t stop your medication unless told to do so by your physician.
• Don’t accept or exchange medication with another person. What is right for one person may be dangerous for another.
• Don’t drive or operate heavy machinery if you feel drowsy from your medication.
• Don’t mix medications in one container. This can lead to chemical interactions- or your taking the wrong drug.
• Don’t let your medication run out before ordering more refills. Stopping your medicine could cause a flare of your disease.
• Don’t take old medication. Outdated medication may be ineffective- or dangerous.
• Don’t expect your medications to make you feel better immediately. It may take days, weeks, or even months before you notice a difference in the way you feel.
• Don’t ever change your medication dose on your own. If one tablet is good for you, two are not necessarily better and may even be dangerous.
• Don’t expect medication alone to do the job. A combination of prescribed rest, exercise, medication, joint protection, weight control, and continued medical follow up are essential to achieve adequate control of arthritis.
Anti Inflammatory Drugs A discussion of anti inflammatory drug therapy for the treatment of arthritis. While anti inflammatory drugs may be helpful for many patients, they are not a panacea and are also capable of causing many potential side effects. They should only be used with the advice of a knowledgeable physician. Anti-inflammatory drugs act by blocking the effects of prostaglandins. This effect is a two-edged sword. Blocking inflammation is one edge; potential side-effects are the other.
Glucocorticoids Glucocorticoids or anti-inflammatory steroids are among the most potent inhibitors of inflammation. When used properly they are helpful. Like many other medicines though, there are potential side-effects to consider.
Anti-malarials used to treat malaria long before they were used to treat arthritis, drugs such as hydroxychloroquine and chloroquine are a mainstay of treatment for milder forms of inflammatory arthritis.
Minocycline Antibiotic therapy for rheumatoid arthritis has long been a controversial topic. In some instances of mild disease, antibiotics such as minocycline may be effective.
Sulfasalazine Sulfasalazine, a sulfa derivative is an effective disease-modifying agent for many types of inflammatory arthritis. it is used more extensively in Europe than it is in the United States.
Methotrexate Methotrexate is the "workhorse" disease-modifying drug used for treating more serious types of inflammatory arthritis. It works by blocking the metabolism of rapidly dividing cells.
Azathioprine Azathioprine is another drug that blocks the metabolism of cells and is used as a disease-modifying agent in severe forms of inflammatory arthritis.
Gout medicines Gout is a disease that is caused by the excessive deposition of monosodium urate crystals. This problem occurs as a result of the inability of the body to get rid of uric acid, a by-product of metabolism, quickly enough. A discussion of the use of gout medicines is the topic of this page.
Leflunomide leflunomide is another anti-metabolite used in the treatment of rheumatoid arthritis and psoriatic arthritis. While effective, it has been supplanted, for the most part, by the use of biologic therapy.
Cyclosporine Cyclosporine is a disease modifying drug for rheumatoid arthritis that was "borrowed" from the organ transplant surgeons. Genrally used in combination with methotrexate, its effectiveness is sometimes limited by its toxicity.
Arthritis medicines and the older patient A discussion of the use of arthritis medicines in older patients- what to watch for. Older patients have a slower metabolism... and they are often on more than one medication. Caution must be exercised.
Prednisone tapering side effects Prednisone tapering- lowering the dose- is an art. Physician skill and experience is essential to proper steroid reduction.
Dealing with side effects of prednisone Of all the anti-inflammatory drugs used to treat arthritis, no drug is as effective- or as dangerous- as prednisone. This page discusses the potential pitfalls.
Stopping the use of prednisone Prednisone discontinuation requires a thoughtful experienced approach. Improper management can be life-threatening.
In addition, newer biologic medicines for arthritis are discussed in other pages on this website. You can look under biologics or under the specific medicine. Also, a newer treatment such as stem cell therapy for osteoarthritis also has a page devoted to it. Feel free to explore the site.
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