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Archive for the ‘Drugs’ Category

Arthritis Drugs

March 26, 2014
Acetaminophen

Arthritis Drugs

Arthritis drugs are usually what doctors prescribe to treat osteoarthritis.   Since people respond differently to different types of drugs it’s not always easy to predict how the medications will work.  Potential side effects and poor reactions have to be considered.  It’s not easy to find the right combination of drugs and medications to achieve optimum pain relief for any given patient.  If you have arthritis, you should know as much as possible about your treatment options so you can talk about it with your doctor.

NSAIDs (nonsteroidal anti-inflammatory drugs) are prescribed a lot to treat OA. NSAIDs work by fighting an enzyme called cyclooxygenase (COX). COX comes in two forms: COX-1 and COX-2. NSAIDs can treat COX-1 and COX-2

DMARDs (Disease-Modifying Anti-Rheumatic Drugs) can take weeks or months to start providing pain relief.  DMARDs may be slow acting but they work.  They treat conditions like rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.   These drugs can stop the progression of the disease and limit damage to the joints.

Corticosteroids are usually called “steroids”.  These are strong drugs that quickly reduce swelling and inflammation.   Doses can be all over the place depending on what’s being treated and how agressive the treatment plan is.   Harmful side effects are more likely at high doses or with long-term use.

Analgesics relieve pain. However, unlike NSAIDs, they don’t help with inflammation. Acetaminophen is  a common analgesic.



Herbal supplements like garcinia kola are used to treat a broad range of symptoms. While many are promising, their classification as herbal supplements frees them from many FDA approval requirements and may allow contaminated pills to reach the market.

 

Most drugs designed to treat osteoarthritis do so only by addressing the primary symptoms of the disease: joint pain and inflammation.  Reducing swelling is highly effective at reducing the friction within the joint space, and can slow the deterioration of the cartilage.  This delays the progression of the osteoarthritis and, theoretically, could speed the healing process.  Unfortunately, since cartilage heals so slowly, non-steroidal antiinflammatory drugs (NSAID’s) are often prescribed in large doses over long periods of time.  For some individuals, large quantities of NSAID’s can lead to bad reactions.  These individuals often turn to herbal supplements to replace the NSAID’s in their daily routines.

Recent research in the Journal of Orthopaedic Surgery and Research found that garcinia kola, a common African herbal supplement, is effective in treating osteoarthritis of the knee.  Garcinia kola, like most western osteoarthritis medications, acts as a painkiller and antiinflammatory.  This article confirms that individuals taking garcinia kola did better than those with no treatment, but found that traditional NSAID’s were more effective in reducing knee pain and swelling.

The FDA examines herbal supplements like garcinia kola differently than it checks medications.  This directly leads to a reduction in quality control, and can allow impure products to reach the market.  Always be aware that herbal supplements are not part of the pharmaceutical industry, and so are subjected to less stringent inspections.

While many herbal supplements are promising, they are often less effective than their manufacturers suggest.  Herbal supplements are most appropriate as substitutes for western medications which cannot be taken for a specific reason.  If you hear about a promising herbal supplement, consult your doctor before taking it, and do not assume that it will perform as advertised.



Many. drugs are often employed to treat OA symptoms, but few address the disease directly

Knee osteoarthritis is commonly treated by medications, diets, exercise, braces, and surgery (among other things).  Most medications for osteoarthritis reduce pain and inflammation.  This can indirectly slow the progression of the disease by reducing the fluid in the joint-space (and thereby reducing the pressure on the cartilage).  A new drug, strontium ranelate, delays progression of osteoarthritis by as much as 40%, without employing anti-inflammatories.  This is important because it could potentially be taken in combination with more conventional medications for even more effective treatment.

A recent study presented at the American College of Rheumatology examined the progression of osteoarthritis in more than 1300 seniors over 3 years.  They found that those taking strontium ranelate were 30-40% less likely to require surgery for their osteoarthritis than people taking a placebo.

Strontium ranelate has been approved in Europe, but has not yet been accepted by the FDA.  If the results of this recent study are validated by other papers, US approval should be on the horizon.  So keep your ears open, and when strontium ranelate hits American markets ask your doctor if it could help you.



Aspirin

September 9, 2012

 

Aspirin is in a class of drugs called Anti-inflammatory medications.  Other drugs in this class of medicine  can include ibuprofen and acetaminophen.   Anti inflammatory medications like aspirin help reduce swelling.  Over the counter pain relievers like Bayer are commonly used with success to treat the knee pain associated with osteoarthritis. Aspirin has potential side effects and your body can build up a tolerance. It is important to understand that even over-the-counter medications like aspirin can interact with other medications you may be taking.  Make sure you follow the instructions on the bottle and consult with your primary care physician about aspirin use.

 



Aspirin

Aspirin

Aspirin helps reduce pain, swelling, and fever.  It is a medicine in the salicylates family of chemicals.  It may be one of the most famous and extensively studied medicines in the world.  Aspirin is often recommended, prescribed, and taken to treat the symptoms associated with joint pain, knee pain, osteoarthritis, and rheumatoid arthritis.

Ibuprofen and acetaminophen are often confused for Aspirin.  They are close cousins, but not exactly siblings.  Ibuprofen is a non steroidal anti inflammatory (NSAID), and acetaminophen is in a class of medications called analgesics or pain relievers.

Some brand names you might recognize are below:

Aspirin:  Bufferin, Bayer, Ecotrin

Acetaminophen: Excedrin, Tylenol

NSAID:  Naproxen, Aleve, Advil, Motrin

Each class of arthritis treatment has pros, cons, and side effects.  it is important for your health that you consult with a physician to devise a treatment plan for your arthritis pain.  Self medicating may work at relieving joint pain on a short-term basis, but long term you can destroy your liver, stomach, or mental health with any or all of the above.



Celebrex ad

Celebrex ad

Celebrex is reported to be the top selling arthritis drug with sales exceeding $2 Billion annually.

One of the most alarming side effects of Celebrex is an increase in blood pressure.  Increased blood pressure or hypertension has been reported in 3.9% to 13.4% of patients.  Persistent hypertension can lead to heart failure, stroke, myocardial infarction, arterial aneurysm, and chronic kidney failure.

Any reputable doctor will explain that the best way to ease the pain of your arthritic knees is with exercise and weight loss.  Think about what happens when an overweight person who does not exercise takes a drug that will increase their blood pressure.  Their knees might feel better but for how long?



Celebrex

Celebrex

Celebrex may provide temporary pain relief for the symptoms associated with knee osteoarthritis but it is not a cure.  Once you stop taking the drugs, the pain will return.  And during your brief reprieve from knee pain there is a good chance your digestive tract will suffer.

It has been reported in patients taking Celebrex that:

  • 3.5% to 9.09% experienced nausea
  • 7.32% to 10.4% experienced upper abdominal pain
  • 2.8% to 8.8% experienced dyspepsia (indigestion)
  • 4.9% – 10.5% experienced diarrhea
  • 4.7% experienced gastroesophageal reflux
  • 2.3% experienced flatulence

“Constipation, diverticulitis, dry mouth, dysphagia, eructation, esophagitis, gastritis, gastroenteritis, hemorrhoids, hiatal hernia, melena, stomatitis, tenesmus, tooth disorder, intestinal obstruction, intestinal perforation, GI bleeding, colitis with bleeding, esophageal perforation, pancreatitis, cholelithiasis, and ileus have been reported in less than 2% of the patients.”

Serious gastrointestinal toxicity has been reported in people using Celebrex and could possibly be linked to some deaths.



Celebrex

Celebrex

Celebrex (Celecoxib) is a treatment option for the symptoms associated with knee osteoarthritis.  It is a capsule taken by mouth usually once or twice per day.

The most common side effects of Celebrex are constipation, diarrhea, gas, headaches, heartburn, nausea, sore throat, upset stomach, and stuffy nose.

However severe allergic reactions have also been reported.  Seek medical attention right away if any of these SEVERE side effects occur when using Celebrex:

Rashes, hives, itching, breathing difficulty, tightness in the chest, swelling (mouth, face, lips, or tongue), bloody, black, or tarry stools, change in the amount of urine produced, chest pain, confusion, dark urine, depression, fainting, fast or irregular heartbeat, fever, chills, or persistent sore throat, hearing loss, mental or mood changes, numbness of an arm or leg, one-sided weakness, red, swollen, blistered, or peeling skin, ringing in the ears, seizures, severe headache or dizziness, severe or persistent stomach pain, vomiting, ; sudden or unexplained weight gain, swelling of hands, legs, or feet, unusual bruising or bleeding, unusual joint or muscle pain, unusual tiredness or weakness, vision or speech changes, vomit that looks like coffee grounds, and yellowing of the skin or eyes.

Ask yourself if the risk is worth the reward.



Acetaminophen

Acetaminophen

Acetaminophen is commonly used to relieve fevers, headaches, and minor aches and pains. It is a major ingredient in many cold and flu remedies. It is also used as a short term solution to treat mild knee arthritis. However it has no effect on the underlying inflammation, redness, and joint swelling.

Acetaminophen works by elevating the body’s pain threshold. It relieves pain by requiring the body to produce a greater amount of it before the pain is felt. Current recommendations for treating pain suggest that acetaminophen may be taken for up to 10 days. If symptoms persist, a doctor needs to be consulted to see if acetaminophen use should continue.



Avoid Surgery

Avoid Surgery

Dr. David Hunter from New England Baptist Hospital in Boston and University of Sydney in Australia recently published a study in Arthritis Care & Research.  “Quality of Osteoarthritis Management and the Need for Reform in the US” is research aimed at drawing attention to the fact that health care professionals in the United States often treat the pain and try to increase function in arthritic knees, but seldom try to improve joint structure or try to work with patients on long-term solutions.

The authors of this study recommend conservative treatment options for knee OA, especially avoiding pharmacological solutions.  “Weight management and exercise programs tend to be overlooked by clinicians,” said Dr. Hunter.  “These conservative approaches are beneficial to patients who adhere to weight-loss and exercise programs.”

The study examined prior research on treating osteoarthritis of the knee and found that up to 30% of surgeries are inappropriate!  And as we discussed on this blog arthroscopy should be avoided as a treatment option for knee OA – it doesn’t work yet orthopedic surgeons still perform the operation – every day.

Weight loss and exercise are the best treatment options for knee OA – how many more studies have to be conducted on the subject?  Joint health supplements, and knee braces are conservative treatments that will help you get up and moving.