Rheumatoid Arthritis Treatments – NSAIDs

Rheumatoid Arthritis Treatments

Oral Meds

 

 

There are many different treatments for RA. Some of the more common ones include NSAIDs (non-steroidal anti-inflammatory drugs), DMARDs (disease modifying anti-rheumatic drugs), steroids,  and biologics. Today, I’m focusing on NSAIDs

Anti-inflammatory drugs include (generic names used):

  • Ibuprofen
  • Naproxen Sodium
  • Aspirin
  • Celecoxib
  • Sulindac
  • Oxaprozin
  • Salsalate
  • Diflunisal
  • Piroxicam
  • Indomethacin
  • Etodolac
  • Meloxicam
  • Naproxen
  • Nabumetone
  • Diclofenac

NSAIDs work to decrease inflammation. They can work quite well in RA and other inflammatory diseases, however, they should be used in the lowest dose possible to help decrease the risk of side effects.

Side effects of NSAIDs can include:

  • Ulcers
  • Gastrointestinal bleeding
  • Increased bleeding tendency
  • Liver and/or kidney problems
  • High blood pressure
  • Edema

If you are taking NSAIDs for RA, your doctor will want to periodically assess your liver and kidney function. This is done through blood tests and if your liver enzymes or kidney function is not within range, your physician may ask you to stop the medications.

You should report ulcers or gastrointestinal bleeding to your physician right away. Symptoms of ulcer may include stomach pain and nausea. Gastrointestinal bleeding may present with coffee ground emesis, black or tarry stools, pale skin, severe fatigue.

Please consult your physician for any concerns or before initiating NSAID therapy.


http://www.webmd.com/osteoarthritis/guide/anti-inflammatory-drugs

Harrison’s Rheumatology: Editor Anthony S. Fauci

 

Rheumatoid Arthritis Complications

rt hand 5

Rheumatoid Arthritis Complications

 

Rheumatoid Arthritis is an autoimmune disease that can cause widespread complications.

Muscles and Joints: 

Joint deterioration and deformities making it difficult to perform daily tasks, like buttoning a shirt, pulling up a zipper, tying shoes, or even just pulling on clothing.

Carpal tunnel syndrome

Inflammation may cause tendon rupture. This most commonly affects the tendons on the back of the hands.

Cervical myelopathy – a dislocation of the cervical spine which can put pressure on the spinal cord.

Muscles may become weak and patients may have severe muscle spasms. In the photo below, the toes are spasming and pulling downward.

Spasming Toes

Nerves: Peripheral Neuropathy can result in numbness, tingling, and burning tingling in the hands and feet from nerve damage

Blood/Blood Vessels: Many patients with RA develop anemia, and some of the medications used to treat RA can affect other blood components, like the white blood cells. Anemia can lead to dizziness, weakness, and fatigue.  Decreased white count can make the RA patient more prone to infection.

Inflammation of the blood vessels, or vasculitis is a rare complication of RA. It causes thickening, of the blood vessel walls leading to problems with blood flow through the vessels.

Eyes: Scleritis and Episcleritis – inflammation of the blood vessels of the eye – can cause a gritty sensation and redness of the eyes. This can result in corneal damage.

Increased Risk of Infection: Just having RA makes the patient more prone to infection, but also the medications taken can put the person at a higher risk of developing an infection.

Skin: Rheumatoid nodules develop in about one fifth of RA patients. These nodules are usually under the skin and appear on the forearms, heels, fingers, and elbows. They may develop gradually or appear suddenly. These nodules may also occur in the lungs and heart.

Osteoporosis: Loss of bone density is more common in RA patients.

Lung Issues: Chronic lung diseases like interstitial fibrosis, pulmonary hypertension, pleural effusion, and nodules.

Rheumatoid Lung is a group of lung conditions commonly found in RA patients. It includes nodules, fibrosis, and pleural effusions.

These lung issues may present with symptoms of shortness of breath, chest pain, and cough.

Heart: RA patients have an increased risk for developing heart disease, heart attack, stroke, and blood clots. They also have a higher risk for developing pericarditis – inflammation of the sac surrounding the heart and myocarditis – inflammation of the heart muscle.

Cancer: RA patients have an increased risk of developing lymphoma, leukemia, and other cancers. Use of TNF blockers may possibly lead to an increased risk.

Emotional: Living day to day with a chronic, painful illness may lead to depression and anxiety, yet many RA sufferers don’t discuss this with their physicians.

While there are many complications of RA, getting an early diagnosis and following the treatment plan may help lower your risk of developing any of them.

If you have symptoms of any of the complications of this disease, please talk to your physician about it right away. Delaying may lead to worsening of the condition.

 References:

http://www.nhs.uk/Conditions/Rheumatoid-arthritis/Pages/Complications.aspx

http://umm.edu/health/medical/reports/articles/rheumatoid-arthritis

http://www.nytimes.com/health/guides/disease/rheumatoid-arthritis/complications.html

http://www.healthline.com/health/rheumatoid-arthritis-complications#1

http://www.webmd.com/rheumatoid-arthritis/guide/rheumatoid-arthritis-complications