Examples of arthritis include osteoarthritis, osteoarthritis or aging arthritis (which is the most common type), rheumatoid arthritis or deforming arthritis, gout, arthritis associated with lupus and psoriasis, and infectious arthritis.
Because the most important symptom of arthritis is pain that limits the use of the joint, the medications commonly used to mitigate symptoms are painkillers and anti-inflammatory drugs, medications that we will deal with in this spine.
Because que for many years, opium, a natural product obtained from the poppy plant was the most potent natural analgesic, modern painkillers are classified into two groups: those that are derived from opium (opiates) and those that are not (non-opiates). The most commonly used non-opiate painkillers are aspirin and acetaminophen, while morphine and synthetic morphine derivatives are the most widely used opiates.
Aspirin is a multi-purpose medicine. In addition to its analgesic and anti-inflammatory power, it can be used to prevent digestive cancers (stomach and colon) and a second heart attack. Side effect: The main one is stomach hemorrhage, a complication more dependent on the total dose of aspirin than the time of use of the drug.
Acetaminophen is one of the most commonly used pain relievers and is present in more than 600 medicines sold with or without a prescription. It is very common for example, in cold and flu medicines. Side effect: Because acetaminophen can be toxic to the liver, especially if combined with alcohol, the FDA recently recommended to the public that it avoids taking more than two medications containing acetaminophen.
Opioid painkillers are very powerful and controlled. They are only sold with a prescription, which must be issued by a specially licensed doctor. Side effects: They can be severe and include nausea and constipation, plus they have a huge potential to cause addiction.
Nonsteroidal anti-inflammatory (NSAIDs)
These are a very broad group of medicines that are sold with and without a prescription and are considered very useful in pain management. It is important to know that NSAIDs work by blocking substances called cyclooxygenases (COX), which are of two types COX1 and COX2. COX1 occurs throughout the body, including painful and inflamed areas, while COX2 occurs only in painful and inflamed areas.
That’s why NSAIDs are classified into “non-selective” NSAIDs that inhibit both COX1 and COX2, and ibuprofen, ketoprofen and naproxen are the most commonly used. “selective” COX2 inhibitors are celecoxib,diclofenac, indomethacin and sulindac. The importance of knowing this classification (and asking your doctor what type of NSAIDs is being taken) is because its toxicity is different.
Side effects: “Non-selective” NSAIDs are more toxic to the stomach, while “selective” NSAIDs can cause heart attacks and strokes.
According to the American Heart Association, people suffering from heart disease can still use COX2 inhibitor NSAIDs, as long as they are administered at the minimum dose needed and for the shortest possible time to achieve their effects.
Other side effects of NSAIDs include high pressure, fluid retention, kidney damage, stomach bleeding, anemia, asthma and severe allergies.
Disease-modifying anti-rheumatic drugs (DMARDs)
This is a very heterogeneous group of drugs, some of them very old (such as golden salts, for example) and others very modern (such as biological response modifiers) and used to prevent or modify the progression of more severe inflammatory arthritis such as rheumatoid or deforming arthritis, ankylosing spondylitis and psoriasis-associated arthritis. These medicines are generally used in conjunction with painkillers and NSAIDs.
Some of these ancient medicines, used to also treat other diseases, are gold salts, penicillin, sulfazalacin,chloroquine, methotrexate, azatiprin,cyclosporine and leflunomide. It is very important that before taking any of these medicines, ask your doctor and pharmacist about possible side effects.
Modern drugs called Biological Response Modifiers(BRMs)have been developed after it became known that certain substances present in cells, promote inflammation and promote inflammatory arthritis. One such substance is Alpha Tumor Necrosis Factor (TNF) which can be blocked with drugs such as infliximab (Remicade), etanercept (Embrel)and adalimumab (Humira).
Side effects: These powerful medications have shown excellent activity in delaying damage to swollen joints, unfortunately they have serious side effects related to the development or reactivation of tuberculosis, which is why every patient who will initiate any treatment with any of these drugs should be thoroughly examined to rule out the disease.
These ancient medicines constitute a broad family, which is classified according to their potency. It is important to know that the first known steroid was cortisol, a natural hormone produced by the adrenal glands. Once natural cortisol was known, a huge variety of substances known as steroids, corticosteroids or “cortisones” began to synthesize.
Side effects: These drugs have a powerful anti-inflammatory action, which is a double-edged weapon, because it can also predispose to many infections. Other side effects include fluid retention in the body, which causes bloating and increased blood pressure. Because of their action in sugar metabolism, corticosteroids can produce diabetes and because of their calcium loss effect on bones, they can cause osteoporosis.
And if you’re wondering how is it possible for a drug with so many side effects to be used?, I’m telling you that the benefit of steroids over arthritis is very important; Pain relief and decreased inflammation in patients are spectacular and therefore the beneficial effect justifies the side effects that may occur.
In short, arthritis comprises a wide range of conditions, for which there is also a diverse group of medicines. Accurate diagnosis of arthritis by a medical professional is imperative as it depends on the respective treatment and prognosis.