Rheumatoid Arthritis Education Series
Rheumatoid Arthritis Education Series

NSAIDS and Corticosteroids | Health Cosmos

Published on: March 28, 2017 at 15:11:58 Viewed 28

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Rheumatoid Arthritis Education Series / NSAIDs and Corticosteroids

About this video:

In this episode, Dr. Ariel Teitel, a Rheumatologist at NYU Langone Medical Center, explains the other treatment options that are available if the DMARDs, are not quite working for you; you will not want to miss this one.

Transcript:

Dr. Teitel: DMARDs may take weeks to months to fully work in rheumatoid arthritis. Because of this, other medications are often used with the DMARDs to more quickly provide relief from pain, swelling and stiffness. The non-steroidal anti-inflammatory drugs, or NSAIDs, are one such group. Many of these drugs are available generically, helping to lower their costs. NSAIDs work by blocking the cyclooxygenase enzyme and reducing the production of prostaglandins, which in turn results in decreased inflammation and pain. They block the formation of one of the chemical messengers that causes inflammation. Of course they have their side effects as well, and a lot of that is related to the patient, if the patient already has kidney issues or high blood pressure, then that's something to consider, but in most patients as long as the doctor's aware of these things, takes precautions, follows blood tests, usually you can decrease the chances of problems. I do prescribe steroids to patients routinely, and it can be very helpful in rapidly getting somebody back to work, or back to feeling reasonable, while you're waiting for the other medicines to take effect. Generally speaking in rheumatoid arthritis, the treatment we wanna use the least toxic therapy, in the lowest dose possible, for the least amount of time possible, general. DMARDs may take weeks to months to fully work in rheumatoid arthritis. Because of this, other medications are often used with the DMARDs to more quickly provide relief from pain, swelling and stiffness. The non-steroidal anti-inflammatory drugs, or NSAIDs, are one such group. Many of these drugs are available generically, helping to lower their costs. NSAIDs work by blocking the cyclooxygenase enzyme and reducing the production of prostaglandins, which in turn results in decreased inflammation and pain. NSAIDs may also be associated with serious side effects, especially of the heart, kidney and stomach, and patients should discuss these treatment options with their doctor prior to use. The lowest effective dose and shortest possible treatment time of corticosteroids should be used to help prevent side effects. Long-term use of corticosteroids may be associated with osteoporosis, cataracts, cushingoid symptoms, and alterations in blood glucose levels. Doses may need to be withdrawn slowly to help avoid these side effects. When a small number of joints are affected, corticosteroids such as triamcinolone may be given directly into the joint space and tissue. The route is associated with fewer adverse effects than seen with other injectable routes, but there are limitations on the number of injections that can be given per year. When using corticosteroids long-term, calcium and vitamin D supplements or osteoporosis treatments, such as Fosamax, may be needed to help prevent or treat bone loss. 

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