Arthritis

™Arthritis is a debilitating condition that

affects the jjoints of the human body.
y
™The word "arthritis" is derived from the
Greek words "arthro" meaning joint and
"itis" meaning inflammation.
™Its simplest meaning is inflammation of
the joints.
™The body normal reaction to any sort of
injury
j y or infection is inflammation;; it
involves swelling at the site of injury, pain
and stiffness.
™When this pain and stiffness lasts for an
elongated period and keeps on recurring,
th condition
the diti iis k
known as arthritis.
th iti
™ It can cause degeneration of and
permanent damage to the affected
tissues.
™Arthritis normally affects the tissues and
cartilages
g around the bone jjoints of the
body.
™However, some types of arthritis also
affect other body parts including the skin
and internal organs.
™While there are more than 100 different
types of arthritis known to medical
science the condition has been broadly
science,
categorized into the following types:
 Osteoarthritis

™The most common form of arthritis,

osteoarthritis happens
pp when the
cartilages covering the joints are eroded
over age.
™The lack of cartilage causes the bones to
rub against each other, which leads to
pain
i and d iinflammation.
fl ti
™While the condition can affect any joint in
the body,
body osteoarthritis is mainly found in
the joints of the arms and limbs,
especially the weight bearing joints like
those of the knees and ankles.
 Rheumatoid Arthritis

™Rheumatoid arthritis is caused by the

body's
y own immune system
y attacking
g
itself.

™This attack leads to swelling in the joint

lining, which slowly spreads to
surrounding cartilage and tissue.
™This is a long term condition that mainly
affects the hands,, wrists,, and knee joints,
j ,
though there have been instances of
rheumatoid arthritis being diagnosed in
other
th jjoints
i t as well.
ll

™Severe expression of rheumatoid arthritis

can be found even in the skin, eyes, and
nerves.
nerves
 Gout

™Gout is a reaction of the body in response

to accumulation of a natural waste-
product called uric acid.
™Normally uric acid is excreted from the
body through urine, but when it starts
accumulating due to any blockages in the
elimination
li i ti system,
t it starts
t t fforming
i
needle-like crystals in the joints of the
body.
body
™These crystals lead to inflammation and
pain in the jjoints,, which is commonly
p y
described as gout.

™The big toe, knees and wrist joints are the

parts where gout is normally seen.
 Lupus

™Lupus is similar to rheumatoid arthritis as

it also involves the body's
y immune system
y
attacking the body.

™But while rheumatoid arthritis is mainly

seen in joints, the swelling and
inflammation due to lupus can affect many
different parts including joints, skin,
kidney blood cells
kidney, cells, heart,
heart and lungs.
lungs
™Lupus is a highly chronic form of a
connective tissue disease and can severely y
disturb the lives of patients.
™Patients who have been diagnosed with
any of the above forms of arthritis are
normally put on an intensive treatment
regimen
i as arthritis
th iti h
has the
th ability
bilit tto
render a patient disabled for life if not
treated quickly and effectively.
effectively
™There are a number of different
medications and drugsg available for the
treatment of arthritis. These range from
highly potent prescription drugs to over-
th
the-counter
t medications.
di ti

™Different forms of arthritis call for different

medication and dosage regimens and
doctors should prescribe these on the
basis of their diagnosis of a patient's
condition.
™The major types of arthritis
medications currently y available
include:
™* Non-Steroidal Anti-Inflammatory Drugs
(NSAIDs)
™NSAIDs are the most commonly
prescribed and used drugs for the
treatment of arthritis. There are many
different NSAIDs available from different
pharmaceutical manufacturers.
™NSAIDs work by restricting the enzyme
cyclooxygenase
y yg or COX from workingg in
the body.
™This action relieves the pain caused due to
inflammation and provides relief to
arthritis patients.
™Some of the best known NSAID drugs
include Ansaid, Arthrotec, Cataflam,
Daypro Ibuprofen,
Daypro, Ibuprofen Mobic
Mobic, and
Naproxen.
™Along with their beneficial effects, NSAIDs
also have certain side effects,, the most
common of which include abdominal pain,
diarrhea, heartburn, and upset stomach.

™Long term use of the medications has also

been found to cause stomach ulcers and
serious complications like bleeding and
perforation of the stomach.
stomach
™* Cortico-Steroids
steroids are commonly referred to
™Cortico-steroids
™Cortico
as steroids and are powerful anti-
inflammatory drugs that can quickly
reduce the swelling and pain associated
with arthritis.

™These can treat almost all kinds of

arthritis.
th iti
™Among the more popular and widely
prescribed cortico-steroids are drugs
p g such
as betamethasone, cortisone,
dexamethasone, hydrocortisone,
prednisolone,
d i l andd prednisone.
d i

™Just like NSAIDs, cortico-steroids are also

known to have many side effects, the
biggest being their addictive
characteristics.
™When taken for an extended period of
time,, cortico-steroids can cause addiction,,
so most doctors prefer to inject it directly
into the joint or inflamed area.
™* Over-the-counter Topical Pain Relievers
the counter topical pain relievers are
™Over-the-counter
™Over
also commonly called analgesics.

™These topical medications work by

reducing
g the p
pain caused due to arthritis;;
they do not have any effect on the
inflammation.
™Pain control is a major part of arthritis
treatment and so these medications are
used by millions of arthritis patients.

™Analgesics such as aspirin,

acetaminophen, ibuprofen, and
naproxen are the most widely used over-
the-counter topical pain relievers.
™One reason for the wide popularity of
analgesics
g is that they
y are benign
g
medications that seldom have any major
side-effects.

™The most commonly known adverse

effects of these medications are an upset
stomach and nausea.
™* Gout Medications
™Gout treatment normally involves a three
step approach. The first step is control of
pain through the use of analgesics such as
Tylenol.

™This is followed by treatment with NSAIDs,

colchicines and corticosteroids to bring
d
down th
the iinflammation.
fl ti
™Once the inflammation is under control,
drugs
g are administered to treat the root
cause of accumulation of uric acid.

™There are a number of different drugs

used for this including Anturane,
Benemid, Colchicine, and Zyloprim.
™As the drugs force the removal of uric acid
from the body,y, their most common side
effect is excessive urination, which could
lead to dehydration and a lack of fluids in
th b
the body.
d
™* Chemotherapy Drugs
™While chemotherapy drugs are primarily
used for treatment of cancer, some of
these medications are also beneficial for
the treatment of inflammation caused by a
malfunctioning immune system.

™Chemotherapy drugs slow down the

reproduction
d ti off cells,
ll which
hi h in
i turn
t can
lead to reduction in the inflammation
caused by arthritis.
arthritis
™Not all chemotherapy drugs can be used
for treatment of arthritis.

™The most commonly

y used medications
include Rheumatrax, Imuran, and
Cytoxan.
™As these drugs restrict cell formation, they
can have certain severe side effects
including anemia, low white blood cell
count, low platelet count.

™These drugs can also damage the liver

and urinary tract, cause hair loss and lead
to sterility.
™* COX-2 Inhibitors
™COX-2
™COX 2 inhibitors are a form of NSAIDs and
share the same method of working as
these drugs.

™COX-2 inhibitors are also known as

selective inhibitors as these work by
selectively inhibiting the action of the
cyclooxygenase-2
l 2 enzyme, which
hi h is
i
mainly responsible for inflammation.
™The most commonly prescribed COX-2
inhibitors include Celebrex,, Vioxx,, and
Bextra. The last two medications have
now been taken off the market on account
off th
their
i side
id effects.
ff t
™COX-2 inhibitors share the same side
effects
ff t as NSAIDs,
NSAID though
th h these
th drugs
d are
also known to have severe effects on the
heart and can lead to severe
heart,
hypertension and even heart failure in
some patients.
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™* Biological Response Modifiers (BRMs)
™Biological response modifiers or BRMs are
substances that change the way in which
the body reacts to diseases and infections.

™While these are naturally

y produced
p
substances, medical science has
developed these in the laboratory for use
as arthritis
th iti medications.
di ti
™While highly potent in treating arthritis,
BRMs are also known to have side effects
such as flu-like symptoms, weakness,
fever, appetite loss, vomiting and
di h
diarrhea.

™ Among the better known BRM drugs are

included Enbrel, Humira, Kineret,
Orenica and Remicade
Orenica, Remicade.