clinical pharmacology of anti-inflammatory agents (rheumatic diseases)

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clinical pharmacology of anti-inflammatory agents clinical pharmacology of anti-inflammatory agents rheumatic diseases rheumatic diseases (rheumatism) are painful conditions that affect millions. these diseases cause inflammation, swelling, and pain in the joints or muscles. some rheumatic diseases like osteoarthritis are the result of "wear and tear" to the joints. other rheumatic diseases, such as rheumatoid arthritis, happen when the immune system goes haywire; the immune system attacks the linings of joints, causing joint pain, swelling, and destruction. fibromyalgia osteoarthritis rheumatoid arthritis ra is sometimes called a crippling disease. that's because it can result in permanent joint damage and deformity. ra signs and symptoms include: joint pain, stiffness, and swelling involvement of multiple joints (symmetrical pattern) other organ involvement joint stiffness, especially in the morning fatigue fevers lumps called rheumatoid nodules to diagnose ra, doctor will ask about medical history and do a physical examination. also, x-rays and blood tests will likely …

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) derivatives piroxicam meloxicam tenoxicam droxicam lornoxicam isoxicam fenamic acid derivatives( fenamates ) mefenamic acid meclofenamic acid flufenamic acid tolfenamic acid nsaids selective cox-2 inhibitors (coxibs) celecoxib (fda alert) rofecoxib (withdrawn from market) - increased cardiovascular thrombotic events valdecoxib (withdrawn from market) - increased cardiovascular thrombotic events parecoxib fda withdrawn lumiracoxib tga cancelled registration etoricoxib fda withdrawn firocoxib used in dogs and horses sulphonanilides nimesulide (systemic preparations are banned by several countries for the potential risk of hepatotoxicity) others licofelone acts by inhibiting lox (lipooxygenase) & cox and hence known as 5-lox/cox inhibitor inflammation the cell damage associated with inflammation acts on cell membranes to cause leukocytes to release lysosomal enzymes; arachidonic acid is then liberated from precursor compounds, and various eicosanoids are synthesized. the cyclooxygenase (cox) pathway of arachidonate metabolism produces prostaglandins, which have a variety of effects on blood vessels, on nerve endings, and on cells involved in …

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b (celebrex), blocks cox-2 and has little effect on cox-1, and is therefore further classified as a selective cox-2 inhibitor. selective cox-2 inhibitors cause less bleeding and fewer ulcers than other nsaids. nsaids are generally indicated for the symptomatic relief of the following conditions: rheumatoid arthritis osteoarthritis inflammatory arthropathies (e.g. ankylosing spondylitis, psoriatic arthritis, reiter's syndrome) acute gout dysmenorrhoea (menstrual pain) metastatic bone pain headache and migraine postoperative pain mild-to-moderate pain due to inflammation and tissue injury pyrexia (fever) ileus renal colic they are also given to neonate infants whose ductus arteriosus is not closed within 24 hours of birth aspirin, the only nsaid able to irreversibly inhibit cox-1, is also indicated for inhibition of platelet aggregation. complications of nsaids nsaids are safe drugs. however, they have many side effects. the side effects happen more often when they are used over long periods of time, which is common in arthritis …

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olac limit its use. some surveys suggest that indomethacin or tolmetin are the nsaids associated with the greatest toxicity, while salsalate, aspirin, and ibuprofen are least toxic. the selective cox-2 inhibitors were not included in these analyses. choice of nsaid (cont’d) for patients with renal insufficiency, nonacetylated salicylates may be best. diclofenac and sulindac are associated with more liver function test abnormalities than other nsaids. the relatively expensive, selective cox-2 inhibitor celecoxib, is probably safest for patients at high risk for gastrointestinal bleeding but may have a higher risk of cardiovascular toxicity. celecoxib or a nonselective nsaid plus omeprazole or misoprostol may be appropriate in patients at highest risk for gastrointestinal bleeding; in this subpopulation of patients, they are cost-effective despite their high acquisition costs. the choice of an nsaid thus requires a balance of efficacy, cost-effectiveness, safety, and numerous personal factors (eg, other drugs also being used, concurrent illness, …

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s of corticosteroids the most commonly used corticosteroids are prednisone, prednisolone, and methylprednisolone. corticosteroids can be given orally or put directly into the bloodstream through an intravenous needle. they can also be injected directly into an inflamed spot. corticosteroid cream can be rubbed on the skin. corticosteroids are powerful drugs. but they are also highly toxic. doctors have different opinions about how corticosteroids should be used. corticosteroids can't cure a disease. but they do seem to affect the development of some diseases, including rheumatoid arthritis (ra). some commonly used natural and synthetic corticosteroids for general use short- to medium-acting glucocorticoids: hydrocortisone (cortisol) cortisone prednisone prednisolone methylprednisolone some commonly used natural and synthetic corticosteroids for general use intermediate-acting glucocorticoids triamcinolone paramethasone fluprednisolone long-acting glucocorticoids betamethasone dexamethasone corticosteroids withdrawal when stop taking corticosteroids, the doses will be slowly reduced over a period of days or weeks. even if patient has only been …

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О "clinical pharmacology of anti-inflammatory agents (rheumatic diseases)"

clinical pharmacology of anti-inflammatory agents clinical pharmacology of anti-inflammatory agents rheumatic diseases rheumatic diseases (rheumatism) are painful conditions that affect millions. these diseases cause inflammation, swelling, and pain in the joints or muscles. some rheumatic diseases like osteoarthritis are the result of "wear and tear" to the joints. other rheumatic diseases, such as rheumatoid arthritis, happen when the immune system goes haywire; the immune system attacks the linings of joints, causing joint pain, swelling, and destruction. fibromyalgia osteoarthritis rheumatoid arthritis ra is sometimes called a crippling disease. that's because it can result in permanent joint damage and deformity. ra signs and symptoms include: joint pain, stiffness, and swelling invol...

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