TREATMENT PROGRAM FOR ARTHRITIS

The traditional medical view of rheumatoid arthritis is that it is a chronic illness characterized by spontaneous remissions in most patients who will, with varying degrees of restriction, be able to lead active lives with the use of medications that may (especially the cortisone/steroid drugs) cause more problems than the arthritis itself.
Patient and physician alike are educated not to expect a rapid resolution of the illness, and the outlook is “reasonably optimistic” that conservative treatment can relieve symptoms and keep disability to a minimum. No specific dietary measures or vitamin supplements are suggested, but weight reduction has a high priority in overweight arthritic patients. Associated depression may require psychological support from the attending physician, as well as sedatives or tranquilizers.
The basic program includes rest, medications to suppress inflammation and relieve pain, and physical therapy to preserve joint functions and maintain muscles. Some patients may require surgery.
This drug-oriented program of management may cover a long period of time and be associated with undesirable side effects. It is directed toward the suppression of symptoms, because there is no attention given to the detection and control of the specific identifiable cause(s) of most cases of the disease.
The drug of choice, part of basic conventional management, is aspirin or chemically related drugs known as salicylates. The chemical name for aspirin is acetylsalicylic acid. Salicylates may cause intestinal tract bleeding, dizziness, ringing in the ears (tinnitis), and other symptoms. It must be given with care to patients with stomach ulcers, bleeding tendencies, and asthma.
If the response to salicylates is not satisfactory after two months of treatment with rest and physical therapy, other anti-inflammatory drugs are employed. These are referred to as the non-aspirin NSAIDs – non-steroidal (cortisone-like) anti-inflammatory drugs. They have the same anti-inflammatory activity as aspirin, but it is not possible to predict which drug will be effective in an individual patient. Each drug may have to be tried in a systematic sequence to determine which one will bring about the desired response. These drugs may be taken with aspirin or in place of aspirin.
There are two chemical groups of NSAIDs. The first group is derived from propionic acid and consists of Naprosyn (naproxen), Motrin (ibuprofen) and Nalfon (fenoprofen). The other family comes from indole: Indocin (indomethacin), Tolectin (tolmetin sodium), and Clinoril (sulindac). Many patients taking these NSAIDs will exhibit nervous-system toxicity, including headache and dizziness. Indocin has the greatest potential for gastrointestinal reactions.
*5/295/5*

TREATMENT PROGRAM FOR ARTHRITISThe traditional medical view of rheumatoid arthritis is that it is a chronic illness characterized by spontaneous remissions in most patients who will, with varying degrees of restriction, be able to lead active lives with the use of medications that may (especially the cortisone/steroid drugs) cause more problems than the arthritis itself.Patient and physician alike are educated not to expect a rapid resolution of the illness, and the outlook is “reasonably optimistic” that conservative treatment can relieve symptoms and keep disability to a minimum. No specific dietary measures or vitamin supplements are suggested, but weight reduction has a high priority in overweight arthritic patients. Associated depression may require psychological support from the attending physician, as well as sedatives or tranquilizers.The basic program includes rest, medications to suppress inflammation and relieve pain, and physical therapy to preserve joint functions and maintain muscles. Some patients may require surgery.This drug-oriented program of management may cover a long period of time and be associated with undesirable side effects. It is directed toward the suppression of symptoms, because there is no attention given to the detection and control of the specific identifiable cause(s) of most cases of the disease.The drug of choice, part of basic conventional management, is aspirin or chemically related drugs known as salicylates. The chemical name for aspirin is acetylsalicylic acid. Salicylates may cause intestinal tract bleeding, dizziness, ringing in the ears (tinnitis), and other symptoms. It must be given with care to patients with stomach ulcers, bleeding tendencies, and asthma.If the response to salicylates is not satisfactory after two months of treatment with rest and physical therapy, other anti-inflammatory drugs are employed. These are referred to as the non-aspirin NSAIDs – non-steroidal (cortisone-like) anti-inflammatory drugs. They have the same anti-inflammatory activity as aspirin, but it is not possible to predict which drug will be effective in an individual patient. Each drug may have to be tried in a systematic sequence to determine which one will bring about the desired response. These drugs may be taken with aspirin or in place of aspirin.There are two chemical groups of NSAIDs. The first group is derived from propionic acid and consists of Naprosyn (naproxen), Motrin (ibuprofen) and Nalfon (fenoprofen). The other family comes from indole: Indocin (indomethacin), Tolectin (tolmetin sodium), and Clinoril (sulindac). Many patients taking these NSAIDs will exhibit nervous-system toxicity, including headache and dizziness. Indocin has the greatest potential for gastrointestinal reactions.*5/295/5*

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