Medicines for rheumatoid arthritis are sometimes the only hope for the patients and medicines too cannot cure the condition. Though such a statement may seem disheartening, the fact is modern development in drugs can provide relief to a great extent.
In fact, some experts feel that the only treatment for rheumatoid arthritis is through drugs and physical therapy and if the routine is followed properly a person may live a very normal life even after getting rheumatoid arthritis.
About the Medicines
Use of drugs for treatment of rheumatoid arthritis has come a long way. Now drugs can be used for slowing down the progress of the disease, reducing swelling of the joints, preventing further damage to the joints and also increase the mobility of the patient. Most important of all is that medicines for rheumatoid arthritis can give a person improved quality of life and prevent any permanent damage that can be caused by the condition.
The most popular medicines used for treatment of rheumatoid arthritis are called DMARDs or Disease Modifying Anti-rheumatic Drugs. These can slow or altogether stop joint damages. Early treatment with such drugs can give immense benefits and keep you fit for the rest of the life. Treatment with DMARDs is a long time affair.
However, now and then rheumatoid arthritis patients may need relief from pain and in those situations pain relievers may be used. Apart from these the other categories of drugs used are NSAIDs or Non-steroidal anti-inflammatory drugs, Steroids, Immunosuppressant and TNF-Inhibitors.
The drugs like acetaminophen, tramadol and oxycodone are generally used to reduce pain. But they do not reduce any inflammation or swelling of the joints. Generally they come in non-narcotic and narcotic types and the narcotic ones are considered more potent.
Those having history of drug abuse and alcoholism should be especially careful while using these drugs. The patient must inform the physician about such history as the narcotic analgesics are prescription medicines.
These are the pain relievers and the most popular in this class is aspirin. These drugs act by decreasing the production of prostaglandins or the substances that are responsible for causing pain and inflammation in most of the tissues. However, the use of such drugs is on the decline and their place has been taken over by the NSAIDs.
Normally these drugs should not be administered to children below the age of 16 who are suffering from some form of viral infection. Moreover, people with liver problems, severe anemia and bleeding disorders, peptic ulcer and vitamin K deficiency and women in the last trimester of pregnancy should not take the drug.
Salicylates may interact with diabetes drugs and reduce blood sugar levels. When used in conjunction with NSAIDs, it may cause gastric ulcer and therefore, it should be used in regulated doses. Side effects of the drug include decreased functioning of the kidney.
NSAIDs simply prevent the production of prostaglandin in the body. Thus it prevents pain and inflammation. What these drugs do is block the cyclo-oxygenase or COX enzymes which are actually responsible for production of prostaglandins. Sometimes such drugs are also grouped together with non-selective COX–1 and COX–2 enzyme inhibitors. Usually these drugs are the first prescribed drugs after detection of rheumatoid arthritis. The common drugs include ibuprofen, diclofenac, naproxen, indomethacin, oxaprozin, etc.
People with kidney problems, bleeding problems and those suffering from peptic ulcer should avoid these drugs. Since these drugs can lead to fluid retention, they can increase the blood pressure of a person and decrease the effectiveness of the pressure relieving drugs. As these drugs prevent the production of prostaglandin, they may cause ulcers in the stomach and lead to bleeding in the gastrointestinal tract.
Another drug group that may be mentioned along with these drugs is the selective COX-2 inhibitors. These are modern developments and they are designed to mainly inhibit the COX-2 enzymes. That way they can decrease the amount of prostaglandin at the site of inflammation. So they do not harm the gastrointestinal tract in the way the other drugs do. However, widespread use is yet to start.
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This group consists of a variety of drugs and each act in its special way to give relief to the person. But the common function of all of them is to interact with the immunity process that is related to inflammation. The drugs that fall into this group are azathioprine, cyclosporine, penicillamine, leflunomide, hydroxycholoquine, methotrexate and sulfasalazine, etc. Of these the last four are commonly used. The thing to be careful about is that since these drugs target the body’s immunity system, the person undergoing treatment may become prone to infections. Thus it is recommended that these people remain extra careful about infections and if needed, may undergo regular tests for signs of any infection.
Another group of drugs that are related to the DMARDs is the Biologic DMARDs or Biologic Response Modifiers. They also act on specific points where inflammation occurs and inhibit the main factors that are responsible for the inflammatory condition. In a broader sense, the term Biologic drugs also include the TNF-α inhibitors. TNF- α or Tumor Necrosis Factor- alpha is a substance produced in the body which causes the inflammation.
They lead to conditions like stiffness, swollen joints and cause pain. Some biologic drugs prevent T-cell activation while others prevent or reduce production of IL-1 or interleukin-1, a form of protein produced by the cells as a reactionary measure. The commonly used drugs falling into this category are abatacept, etanercept, infliximab, adalimumab, anakinra, etc.
Steroids, corticosteroids or glucocorticoids are all steroidal drugs which are used for reducing swelling, inflammation and pain. They also help to prevent joint damage. But they have a host of side effects ranging from osteoporosis and glaucoma to abnormality in the hormonal functions of the body. So treatment with these drugs is generally carried on for short time. The drug is even gradually withdrawn at the end of the treatment. Otherwise it may lead to what is known as corticosteroid withdrawal syndrome. Some commonly used corticosteroids are betamethasone and prednisone.
The investigation for finding the perfect drug is always on and the field of research for finding ways to stop or reverse the condition of rheumatism is always expanding. The good news is that new drugs are being introduced almost everyday for those living with rheumatism.