Tocilizumab is sold under the brand name RoActemra. It is used to block the interleukin 6 receptor or IL 6R. Patients with rheumatoid arthritis will be at a high risk of producing this rather harmful protein. Through the use of Tocilizumab you can effectively block this protein. Consequently you will be able to avoid inflammation and damage to the bone structure. The license for Tocilizumab has been limited to individuals with rheumatoid arthritis but there are clinical trials that are looking at the possibility of using it for juvenile arthritis as the case may be. The arthritis has to be active before Tocilizumab will be prescribed and it is important that the patient starts off with one of the DMARD drugs first. Some of the alternatives that might be considered in the initial phase include Rituximab, etanercept and sulfasalazine. Methotrexate is the standard and it is then complemented by other factors.
Using Tocilizumab in a safe environment
It is important that you do not take Tocilizumab if you have any of the contraindications. These include inactive rheumatoid arthritis, failure to use the initial DMARD drugs, pregnancy, breastfeeding and an infection. Likewise the doctor may decide not to prescribe Tocilizumab if the patient has had repeated infections in the past or is suffering from cancer. Liver disease is another indicator that the treatment is not suitable. Patients that have low neutrophils or white blood cells should not take Tocilizumab. In addition a low count of blood platelets is a strong indicator that this type of treatment is inappropriate. Arthritis patients with a history of diverticulitis should not be given the medication as it might make the situation worse.
If you are suffering from arthritis it is important that you get approval from your doctor or consultant rheumatologist before taking Tocilizumab. The medication is administered using an intravenous infusion once every four weeks. The treatment phases will take about one hour and must be supervised by competent members of staff in order to prevent any problems. A biological therapy alert card should be given to the patient just in case they need emergency treatment. The reduction in joint pain and inflammation should commence about two weeks after the first bout but it can start twelve weeks later. Meanwhile the reaction of the patient must be monitored just in case they develop certain complications.
Some patients have reported side effects due to Tocilizumab. These include dizziness, a headache, runny nose, sore throat, mouth ulcers, high blood pressure and conjunctivitis. The patient may also develop an itch and skin rash. The treatment has been associated with gastritis and inflammation on the site. This medication relates to the immune system and therefore care must be taken to ensure that the patient is not open to opportunistic infections. These vary from time to time according to the way that the treatment program has been handled. There are certain occasions when the treatment will have to be modified in order to secure maximum advantage for the patient. All these decisions are taken in consultation with the doctor.
Sulfasalazine has long been thought of as one of the most effective ways to deal with arthritis. It falls within the DMARD category of disease modifying anti rheumatic drugs. They help to deal with the condition through dampening the disease process. This is different from the other programs where the condition is effectively managed as an ongoing irritant to the patient. In other words, the alternative treatments tend to focus on the management of symptoms rather than dealing with the underlying condition. In some ways this is a short term strategy that will not improve the quality of life for the patient on a long term basis. However it may be the only pragmatic choice that is open to the physicians handling the case. The drug is given in the form of Salazopyrin EN tablets. These tablets are coated so that they do not dissolve too quickly once they are in the stomach. This method for taking Sulfasalazine might reduce the incidence of stomach upsets following the medication.
The prescription process for Sulfasalazine
This type of medication is prescribed in order to limit the impact of the various symptoms that can affect the patient. It is also effective in the treatment of psoriatic arthritis. The medication is given in the form of a tablet which should be taken with a glass of water. Do not crash or attempt to chew the Sulfasalazine tablets because that might harm your digestive system. The medication is done on the basis of a progression starting with the low dosage and then working up to the correct level depending on the condition of the patient. The standard dosage is a five hundred milligram tablet that is taken daily. The normal course of the initial phase of the treatment is four weeks but it might be extended if the circumstances are right for such an extension. It would also be possible to take two tablets a day as long as the active ingredients have been adjusted accordingly. Sulfasalazine is an effective treatment but the patient will require some monitoring.
This medication does not work immediately and is therefore associated with treatment for a chronic condition. The patient has to wait for the full impact of the medication to take place. This normally occurs within about twelve weeks. Some patients have reported nausea upon taking Sulfasalazine while others suffer from diarrhea and stomach pain. You could experience dizziness and rashes. Headache is another side effect that is common amongst patients. These side effects will be intensive in the first three months of the treatment but may subside as the body gets used to the new regime. If the symptoms become very serious then it might be a good idea to inform your physician so that they can take corrective measures accordingly. Sulfasalazine affects the blood count and therefore you should get help if there are indications that your immune system is compromised. Some of these symptoms include fever and a sore throat. Other patients will suffer from unexplained bruising and other signs of an infection.
The use of steroid tablets as a form of arthritis treatment is not without controversy. Sports people in particular might end up losing their professional careers if they take this medication without authorization. There are some naturally occurring steroids such as cortisol and they come in the form of hormones that help the body to function well. The use of manmade steroid tablets can have an impact on the level of inflammation that the patient is experiencing. With the right type of treatment, it is possible to improve the quality of life for the patient. The commercial forms of steroid tablets include Prednisolone, which is quite popular when dealing with rheumatism.
The development of steroid tablets as treatment for arthritis
Inflammation is one of the overriding symptoms that are associated with arthritis. Therefore the treatment programs will attempt to tackle this symptom as a priority. In the case of steroid tablets, this is where the attention is focused. Prednisolone has been given to patients in the form of a tablet or it might be modified to include the form known as “enteric coated” medication. This coating ensures that the medication dissolves slowly in the stomach. In that sense, the patient will have long lasting benefits from the treatment program. The conditions that are managed using steroid tablets include rheumatoid arthritis, polymyalgia rheumatica or PMR and systemic lupus erythematosus or SLE. They tend to reduce the swelling associated with these conditions.
Patients that simultaneously suffer from indigestion will be required to take the form of medication that is coated. This is done in order to protect the stomach from high dosages of the active ingredients. Patients need to take Prednisolone once a day. The morning is the ideal time and you should endeavor to eat some food before taking the medication. The use of steroid tablets might be prescribed on an alternate day basis. If the tablet is coated then you need to swallow it whole in order to avoid upsetting your stomach. Your weight and the severity of the disease will be influential factors in determining the correct dosage that will be applied. Where the patients have been on steroid tablets for extended periods of time, the doctor will attempt to reduce the dosage gradually until they are no longer dependent on the medication.
Of course there are cases where steroid tablets become part of the treatment program for a chronic condition. The patient will remain on these tablets on an indefinite basis but the level of dosage will be significantly reduced in order to minimize the side effects. It is important that you do not stop to take your tablets unless there is clear guidance from the doctor. Stopping steroids on an abrupt basis can be very dangerous to the health of the patient. Patients that take steroid tablets should carry a card in case emergency teams need to deal with them. Likewise any adverse side effects must be reported to the clinician that is responsible for handling the case.
Rituximab is sold under the brand name MabThera. It is able to remove B cells from within the body frame. These are white blood cells that produce certain antibodies in response to viruses and germs. They might also react to substances which the body perceives to be dangerous or foreign. In some cases these reactions are not justified because the substances are in fact harmless. That is where an autoimmune condition might be identified. There are certain forms of arthritis that are particularly associated with an autoimmune disorder. In such cases Rituximab might be part of the treatment program that is recommended for patients. The prescription for this type of treatment is normally associated with patients that have rheumatoid arthritis. Rheumatoid factors are targeted using this treatment program. After some months the body will switch from producing rheumatoid factors to producing good antibodies.
Taking Rituximab with diligence and safety in mind
Like all forms of arthritis treatment, Rituximab requires the supervision of a clinician. They will be able to look at the symptoms that the patient is suffering from and they could also recommend methodologies through which the side effects of the condition might be minimized. The prescription normally happens when the patient has developed stiffness and pain in the affected areas. The treatment is at the top of the scale and the patient will be required to first try out alternatives. These alternatives include gold injections, sulfasalazine, methotrexate and the anti TNF drugs. The anti TNF drugs include adalimumab, etanercept and Infliximab. Sometimes the patient cannot use any of these medications and therefore Rituximab becomes the only viable alternative.
The contraindications for Rituximab include inactive rheumatoid arthritis, failure to take standard treatments first, pregnancy, breastfeeding and infections. The clinicians will look at the medical record of the patient and might even interview them in order to ascertain whether there are any contraindications. Some patients are forbidden from taking Rituximab on account of the fact that they get short of breath very easily or that they have low antibody levels. Where the patient has HIV it is important that the clinician handling that condition is consulted so that a comprehensive management program is in place. These are individuals with a high risk of developing a compromised immune system. Therefore it only makes sense to proceed cautiously in order to ensure that no harm is done to the patient during the course of treatment.
The use of Rituximab is not unknown in cases of systemic lupus erythematosus or SLE. Nonetheless there has to be a test to confirm that the patient is not seronegative for rheumatoid factors. In cases where there are no rheumatoid factors, then the use of Rituximab might be counterproductive. Clinical supervision is part of the process of using Rituximab. There have to be checks that ensure the welfare of the patient. Likewise blood tests will be carried out in order to ascertain the efficacy of the treatment. In due course it might be complemented by other forms of treatment which the patient is able to handle.
One of the treatment programs that you can have for arthritis is Pamidronate. The brand name for this product is Aredia and it has been one of the popular alternatives for patients with this condition. It falls within the bisphosphonates in terms of its chemical composition. Sometimes people forget that bones are living tissues. New bones are created as old ones die away. A failure to balance the creation of new bones with older bones can create the ideal conditions for arthritis to prosper. Therefore it is important to access treatment early so that some of the more painful symptoms are alleviated. Apart from arthritis, this form of treatment is used against Paget’s disease. The method of application is through an injection and it can therefore be prescribed for patients who do not tolerate other forms of bisphosphonate.
Groups of patients that might benefit from pamidronate
The use of pamidronate has been associated with women who develop osteoporosis after menopause. It might be also used to complement the corticosteroids that are used to deal with rheumatic arthritis. It prevents fractures and other injuries which are typical of this condition. The disease activity in Paget’s disease will be significantly reduced. Patients that have high blood calcium levels may be given this treatment in order to bring their levels down. This is an essential method for dealing with certain types of cancers. The treatment is provided through the administration of a slow injection in a vein. This method is known as intravenous infusion within medical circles. It is imperative that the infusions are given under medical supervision within a hospital setting. The infusion process can last up to one hour depending on the dosage and the reactions by the patient. The condition will then gradually respond to the treatment which has been provided.
The infusions will be given every three months in cases of osteoporosis. They could be continued on a permanent basis if the patient is responding well to them. In cases of Paget’s disease, the patient and doctor will come to a reasonable schedule for the infusions. The course will normally last from four weeks to eight weeks. Of course the infusions of Pamidronate will be repeated if the condition flares up in due course. The primary objective is to ensure that the patient has the best care possible in all circumstances. Patients might also be advised to take vitamin D and calcium in order to improve the state of their bone structures. In osteoporosis cases Pamidronate will start to work in twelve months. The area that will be targeted is bone density. With Paget’s disease the time frame for the medication to work is about three to six months.
The side effects include a mild fever. This will occur at the beginning of the treatment but only lasts for a maximum of forty eight hours. Sometimes the patient will develop flu-like symptoms including shivering and a sore throat. It is important that Pamidronate is taken under the supervision of a clinician so that the side effects can be dealt with effectively.
The development of osteoporosis will lead to a change in the bone structure. That means that there is less protection for vulnerable internal organs. The development of this condition requires an appropriate medical response. That might be in the form of various drugs that are meant to reduce the pain for the patient. In selecting this medication, there has to be a clear view on the side effects that might affect the patient. At the end of the day, the ultimate aim of the treatment is to improve the quality of life for the patient. This is an objective that is well within the means of most people that follow the program. In general terms the drugs for osteoporosis have to increase the bone strength or prevent their deterioration. If the bone is weak then it is susceptible to breaking or fracturing. The diagnostic assessment will look at the risk factors such as morbid obesity. There is also a scan that will look at the body structure from different points of view.
The right drugs for osteoporosis
You need to ensure that you get the best medication for the condition. That means that you need to look at the contraindications as well as the possible side effects. If all those factors do not concern you, then probably you are on the right track in terms of finding the right medication in the circumstances. The density of the bone will be an important consideration in all circumstances depending on how you see things. It is imperative that you take the necessary steps to keep healthy. The use of medication will be the starting point but you might go on a diet in order to reduce your weight levels. Patients need to improve their mobility because it is an important consideration for their social life. If they are kept confined then it will probably lead to social isolation. That is not an outcome that is desirable under any circumstances.
The treatment will involve a specific intervention against the risk factors. The drug therapy will then work to support the bone structure in all circumstances. Bisphosphonates have long been used as a method to keep the development of osteoporosis under control. They are preferred because of their ability to manage the condition without leading to negative side effects. These forms of treatment can be taken by mouth or through intravenous means. The clinician handling the case will be able to provide further advice to the patients in terms of the best way to handle the conditions. Some patients take the option to have treatment by mouth. The commercial versions that are available under this banner include etidronate, ibandronate, alendronate and risedronate. The absorption rate is improved if you have a meal. Water has to be taken with the medication and you need to remain upright for one hour after the treatment. That course of action will ensure that you do not suffer some of the side effects that have been associated with drugs for osteoporosis.
Non-steroidal anti-inflammatory drugs (NSAIDs) are some of the best known methods for treating arthritis. Generally speaking, they improve the quality of life for the patient and they also help them to build up the pain barrier against the condition. They included branded items such as naproxen, ibuprofen, aspirin, diclofenac, indometacin and ketoprofen. These types of medication specifically attack the inflammation in the joints and they help the patient to avoid using steroids. Steroids have so many negative aspects that many patients are reluctant to include them within their treatment program. There is a specific category that is known as the Coxibs. These include the Cox 2 specific interventions. They are likely to perform a function that is similar to that of the Non-steroidal anti-inflammatory drugs (NSAIDs). These Coxibs have one advantage in as much as they are less likely to cause a stomach upset, indigestion or heartburn. That means that they are a good alternative. Commercial examples include etoricoxib or Arcoxia and celecoxib or Celebrex.
Treat for arthritis in terms of reducing pain
Pain management is a priority for arthritis patients and therefore the Non-steroidal anti-inflammatory drugs (NSAIDs) are seen as an essential item within the treatment program. Patients with arthritis suffer from joint stiffness and this medication will help them to get rid of some of these symptoms. They also help them to improve the long term prognosis on the condition. These types of medication are often complemented by different steps. In particular there is a tendency to look at the provision of medication from the point of view of increasing the quality of life for the patient. Patients will be required to take the medication in form of tablets or capsules. They could also be available in the form of a liquid suspension. Other forms include a suppository or a topical gel. The aim is to get to get the Non-steroidal anti-inflammatory drugs (NSAIDs) to the specific area as quickly as possible. The method of absorption that is quickest will be preferred over the ones that act slowly.
When you are taking the medication in the form of capsules, it is important that you take them with a full glass of liquid. It is also preferable that you take the medication after a meal. The Non-steroidal anti-inflammatory drugs (NSAIDs) that act on a slow release basis might affect your digestive system. Some doctors prefer to prescribe alternative medication or complementary medication in order to calm the stomach as the patient starts the treatment program. It is imperative that you take the correct dosage. This sort of treatment can vary in its effectiveness and therefore an overdose might cause you adverse effects. You also need to watch out for the side effects. Some patients will feel dizzy and generally ill after a course of Non-steroidal anti-inflammatory drugs (NSAIDs). If you suffer from heart disease or are pregnant then you should think twice before taking on this medication. Likewise if there is a history of allergies in your family, it is important that you first ascertain your reactions.
The use of Mycophenolate has long been known as an effective treatment for arthritis. It is sold under the full name of mycophenolate mofetil while the brand name is CellCept. This drug is used to treat a series of rheumatic diseases. There have been instances where Mycophenolate has been used following an organ transplant. You take the medication in the form of a capsule on a daily basis. You need to take the capsule with a glass of water as well as food. It should not be crushed but swallowed whole as per the instructions from the physician. This is slow acting medication and you might see the first results after three months. On the other hand it is very effective in dealing with long term arthritis.
The safe management of arthritis using Mycophenolate
It is important that you follow all the rules that govern the use of Mycophenolate. Some patients follow the right methods but then end up with certain side effects such as diarrhea and nausea. This sort of treatment will almost certainly affect your blood count. Therefore you need to be on the lookout for opportunistic diseases that might attack your body. In extreme cases you might have problems with your kidney after taking this medication. You need to keep the physician informed about your condition and the steps that you are taking to resolve the issues. The medication will affect your immunity and therefore patients should not be immunized with live vaccines. Examples of these live vaccines include Yellow fever. If he patient has to take Rubella immunization due to pregnancy, then they need to take steps to protect their body from opportunistic diseases.
It might be recommended that you take Pneumovax to protect against the most common types of pneumonia. Flu vaccines might be recommended. It is also important that you restrict the amount of alcohol that you take because Mycophenolate affects. Therefore the liver will not be in a position to deal with binge drinking. In general terms you should not be drinking heavily whilst on medication. It will affect your sense of judgment and might make the side effects worse. The consumption of alcohol is bad enough as it is but the situation will be made worse if you are taking Mycophenolate as well. The doctor will emphasize this point if they are aware that you have an alcohol problem.
Parenting and Mycophenolate
Pregnant women need to be wary of taking Mycophenolate because it can affect their child through secondary transmission. The window is not to become pregnant six weeks after stopping the medication completely. Your doctor might be able to find alternative forms of arthritis treatment that do not place your child in danger. It is imperative that they are involved in all the decisions that affect the way that you take medicine. Some of these combination therapies can be very challenging if you do not take the time to use them effectively. Do not breastfeed when you are taking the medication because it can pass on to the child through milk.
Often Methotrexate is considered to be a half way drug which the patients take before progression to the more challenging forms of medication. It is part of the DMARD drugs and is particularly effective with rheumatoid arthritis. The medication is in the form of a tablet that is taken once a week. You can crush the tablets if you find this method more palatable. The tablets normally weigh about 2.5 mg. Sometimes the doctor might decide that the dosage might be increased to the 10 mg. You will then have to take it less often. The color coding on the medication ensures that there is no chance of making a mistake. There are instances where the medication will be taken by injection near the thigh or buttock. It has now been licensed to be used intravenously. This happens where the patient is unable to tolerate standard Methotrexate tablets.
Using Methotrexate responsibly
It is imperative that you use Methotrexate responsibly. That means that you need to look out for any side effects that might indicate that the body is not taking the medication well. You need to watch the dosage to ensure that it does not exceed the maximum requirements. You will begin to see a change in your condition within twelve weeks of your first tablet or injection. Some patients have reacted to the treatment through nausea, diarrhea, hair loss, mouth ulcers and skin rashes. It is imperative that all these symptoms are discussed with your physician. They might be able to give you practical tips on how you might handle the condition. At the same time they might stop the treatment if it becomes clear that the body is not reacting well to the treatment program. Methotrexate has been known to affect your blood count.
In some cases the use of Methotrexate has lead to respiratory problems as well as inflammation of the lung. Other patients report that they develop shingles or chicken pox. This is a classic example that the immune system is being compromised. Patients might require antiviral treatment in order to combat the development of these conditions. You are advised to take folic acid tablets if you are on Methotrexate. These are essentially good sources of vitamins. It is important that you discuss the options with your doctor. They will know your medical history and might make some important recommendations that will improve your prognosis. In extreme cases you might end up with liver problems.
Clinical management of arthritis using Methotrexate
The possibility of drug reactions with Methotrexate is limited. This is not a painkiller and therefore you might need some painkillers to deal with the practical signs of the disease. Make sure that you tell your doctor about any medication that you are taking. It will help them to make the right decisions. This is often a type of medication that is used before the condition escalates. At the higher levels of arthritis you might be taken off Methotrexate and then put on another form of medication depending on your condition at the time.
There are patients who are positively terrified by the prospect of local steroid injections. It is an invasive sort of treatment and the society today has been conditioned to instinctively fear steroids. Nevertheless they serve a very important purpose in the treatment of diseases. You will get relief from the swollen joint. In terms of the side effects, you will be targeting a specific part of the body. Therefore you do not have a high risk of systemic side effects across the entire system. This is the sort of support that is important for patients from all walks of life. If the joint is injected then it becomes the intra articular injection. Sometimes the clinician will recommend that the injection is merely near the joint. The soft issue injections have been found to be effect in certain instances.
Using the local steroid injections correctly
First of all it is up to the clinician to assess the part of the body that will need the treatment. They will then give you specific instructions on how to achieve the treatment program. You need to listen to the treatment program that has been provided. Steroids have long been known to fight inflammation. The preparations include hydrocortisone, Prednisolone, methylprednisolone and triamcinolone. These vary in strength and therefore you need to make a decision on how you are going to use them. If you are suffering from rheumatoid arthritis, it might be that the local steroid injections are the only way in which they can keep control over the inflammation. It also benefits from the fact that you are targeting a specific area of the body. This procedure has to be managed by your doctor or a qualified rheumatologist. They will also adjust the dosage according to your needs at the time.
It might be necessary to introduce a local anesthetic at the same time. It will give you quick relief and ensure that the quality of life that you have is increased. The temporary relief is then followed by the long term management of the condition which arises from the various treatment programs. The weight bearing joints are the one that need the most support. You should give them some rest after the injection but then start the process of keeping them active. It might be necessary to incorporate some physiotherapy into the things that you are doing. This will give you the confidence to start moving again. Arthritis can become a crippling condition but with the right treatment you might be able to get your freedom back. At the same time you should not strain the joints too much or they could relapse.
Local treatment with the local steroid injections
Patients that fear medication in general might be enthusiastic about local steroid injections because they target a specific part of the body rather than running round everything. This is a particular point of contention but you might benefit from the treatment program in this way. It is certainly preferable to simply taking steroids regardless of their action.