ARTHRITIS
ARTHRITIS!
‘Inflammation-Weakness-Painful-Tenderness-Fatigue’
Do you heard about Arthritis
before???
Let’s Start To Learn About
Arthritis 😊
Arthritis
- Is a chronic disorder of the joints characterized by pain and inflammation.
- There is often a limitation or loss of movement of the part affected.
- Arthritis may take on many forms and the most common are:
- There are general symptoms that are common to all of these forms;
- If the common symptoms are observed for more than two weeks, it is highly possible that a patient is suffering from arthritis.
- These conditions, it is best to see a healthcare professional specializing in the field, i.e.an orthopedist or a rheumatologist.
Let’s
continue read for the most common arthritis in Malaysia & Worldwide…
1. Osteoarthritis
Ø Osteoarthritis (OA) is a progressive joint disease due to failure in
repair of joint damage. This may arise as a result of biomechanical,
biochemical and/or genetics factors. The process may involve one or multiple
joints.
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Symptoms (OA)
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Sign (OA)
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Treatment (OA):
Oral Treatment;
- Simple analgesics – Paracetamol
- Weak opioid analgesics – Tramadol
- Analgesics with anti-inflammatory properties – NSAIDS and COOX-2 Inhibitors
- Nutraceutical – Glucosamine , Chondroitin ,
*please do refer your Doctor or Pharmacist before taking any medication*
Topical
Treatment;
- Capsaicin
- Methyl salicylate
- Topical analgesics can be in the form of gels, cream and transdermal patches.
2. Rheumatoid arthritis
Ø Is an autoimmune disease which causes joints lined with synovium to
become inflamed, swollen, stiff, and painful, and leads to join erosion. It is
multisystem disorder which can affect many organs including the eyes, lungs,
heart, and blood vessels. The aim of treatment is to decrease pain and
inflammation, prevent joint damage, and ultimately induce remission of disease.
Symptoms (RA):
Those affected by the disease develop joint
pain, swelling and early morning stiffness. The pain is worse in the morning
but eases off as the day progresses. Most commonly affected joints are small
joints of the hands and feet. However, the wrists, elbows, shoulders and knees
can also be involved. There is early morning stiffness which may cause
difficulty in moving and will be relieved with activity.
RA is a long-term disease characterized by
periods of joint inactivity and flare-ups.
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Complications (RA)
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Treatment (RA):
- Joint protection very important
- Joint exercise – to help maintain normal joint movements and prevent deformities. You may obtain advice from the physiotherapist
- Splints and assistive devices. Consultation with an occupational therapist is useful to teach you more efficient ways of using your joints and how to cope with rheumatoid arthritis in daily living.
- Medications to relieve pain like non-steroidal anti-inflammatory drugs (NSAIDs)
- Medication to modify the disease (DMARD, disease-modifying anti-rheumatic drugs) like sulphasalazine, methotrexate and others.
- Steroids – they are used to reduce inflammation and as a bringing therapy while waiting for DMARDs to have an effect. However, they are not used for long-term due to its many side effects.
- Surgery – reserved for people who have more severe conditions (i.e. damaged joints) with deformed joints
3. Gouty arthritis
Ø Gout is a type of arthritis that causing inflammation, usually
affects one joint at a time, often the joint in the big toe, which occurred
suddenly. It is caused by deposition crystals of uric acid in the joints.
Ø The crystals irritate the tissues in the joint to cause
inflammation, swelling and pain. However, in severe gout, many other joints can
also be affected. This is known as polyarticular gout. The pain is likely to be
most severe within the first 12 to 24 hours after it begins.
Ø Triggers for attacks include surgery, dehydration, drinking
sweetened with sugar or high-fructose syrup, alcohol, red meat and seafood.
Ø Chronic gout treated with medications that can lower the levels of
uric acid in the body. If left untreated, gout can cause irreversible damage
with kidney problems and deposition of uric acid in tissues.
Ø Men are more likely to get affected than women, but women become
increasingly susceptible to gout after menopause.
Treatment (GA):
When gout pain experienced is mild,
infrequent and not serious, it can be treated with diet and lifestyle changes.
However, when the attacks became frequent, the uric acid levels is very high,
the production of kidney stones, the formation of tophi or there is evidence of
joint damage, the treatment usually involves medications.
Selected remedy will be based on current
health and the severity of gout. Gout medications can be used to treat acute
attacks, lower the uric acid levels in the blood, prophylactic medication ae
used to reduce the risk of recurrent attacks in the first six months of
treatment and medication to reduce the risk of complications from gout, such as
the development of tophi (small lumps forming under the skin) from urate
crystal deposits.
Types of Medication;
a) Non -steroidal
anti-inflammatory drugs (NSAIDs). Eg: ibuprofen, naproxen and indomethacin
NSAIDs may control inflammation and pain in the affected
joint. Doctor may prescribe a higher dose to stop an acute attack, followed by
a lower daily dose to prevent recurrent attacks in the future. It can relieve a
gout attack quickly (within 12-24 hours). However, NSAIDs are used only in a
short period only.
b) Colchicine
If you’re unable to take NSAIDs, your doctor may
recommend colchicine, a drug that is effective in reducing gout pain especially
when given during an acute attack. Doctor may prescribe a lower daily dose of
colchine to prevent recurrent attacks in the future.
c) Corticosteroids
Corticosteroids such as prednisolone may control gout
inflammation and pain. Corticosteroids are generally reserved for people who
cannot take either NSAIDs or colchicine.
Medication to reduce the
risk of complication associated with gout.
Options include :
v Uric acid lowering medications.
Drugs called xanthine oxidase inhibitors, such as
allopurinol. This medication may limit the amount of uric acid in the blood.
Allopurinol is a commonly used medication to prevent gout attacks. Allopurinol
does not have any side effect during a gout attacks and its not a pain killer.
Allopurinol should not be started at the beginning of an attacks of gout.
Normally, allopurinol will be given 1 to 2 weeks after the attacks. It works by
reducing levels of uric acid in the blood. It takes about 2-3 months to be
fully effective. It should be taken daily to maintain normal levels of uric
acid to prevent gout attacks.
As a general rule, allopurinol commonly given to :
1.
Patients who have had two or
more attacks of gout within a year.
2.
Have one or more tophi (small
lumps forming under the skin).
3.
Have any joint or kidney damage
due to gout.
4.
There is one or more kidney
stones are formed from uric acid.
*please do refer your Doctor or Pharmacist before
taking any medication*
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Tips To Prevent Gout Attacks
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ATTENTION!!
If you find out that you have any of this symptom please refer your Doctor or Pharmacist as soon as possible. Stay with our Channel on Facebook , Instagram and our FB Page (I Am Healthy) for more info and current issue that we're focusing on from time to time. Don't forget to share your opinion and experience with us. Sharing is Caring!! Love from SB.
References
4. Mims Pharmacy Patient
Counselling Guide Malaysia 2017/2018
5. Oxford Handbook Of
Clinical Pharmacy Second Edition
6. Protocol Medication Therapy
Adherence Clinic/Rheumatology
7. Clinical Practice
Guidelines Management Of Gout
(MOH/P/PAK/172.08 (GU) OCT 2008)
8. Clinical Practice
Guidelines Management Of Osteoarthritis (Second Edition)
Prepared
by; Nur Hazida Binti Abdul Jabar 😊
Position;
Assistant Pharmacist
“Everything Good That
Happen To You Is From God, Everything Bad That Happen To You Is From Your Own
Action.”
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