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.
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.
Leflunomide falls under the category of DMARD drugs that attack the condition instead of just concentrating on just its symptoms. It is primarily associated with rheumatoid arthritis and that is why it might have negative effects on your immune system. Patients that have used this form of treatment have reported that they get relief from pain as well as the general stiffness of the joint which is a characteristic of this disease. This is the treatment that might take away the possibility of falling into a serious disability.
The procedure for taking Leflunomide
You need to take one tablet a day. The medication can be taken at any time during the day and is therefore practical for people that are working away from home. You should try to get into a routine where you consume the medication at the same time during the day. That will help you in the long run. The doctor will be supervising the medication even when they are not directly in contact with you when you take the medication. They might recommend tablets of about 10 mg or they could increase it to 20 mg depending on how the body is responding. As a general principle, you should not remain on medication unless it is absolutely necessary. The reactive status of the drug is not immediate. You might see the first signs of improvement in about six weeks. It will take up to six months before you feel the full benefit of the medication.
Some of the side effects that are associated with Leflunomide include nausea as well as diarrhea. You could get mouth ulcers as well as unexplained weight loss. Patients might suffer from stomach pain as well as dizziness. It has been known to bring on constant headaches and migraines. Hair loss might be accompanied by dry skin as well as an increase in blood pressure. All these are very serious side effects and you have to have a discussion with your physician as to whether it is feasible to continue with the treatment in light of the side effects that are described. The use of Leflunomide might affect the blood count. That means that your body is vulnerable to infection. Eventually you might get irreversible liver damage if you do not take corrective measures.
Leflunomide and the immune system
If you look at the symptoms that are associated with taking Leflunomide, they are very similar to the ones that would be faced by a patient whose immune system has been compromised. Arthritis that is a result of autoimmune diseases might be treated by suppressing the activity of the immunity system. Nevertheless this course of action might have unintended consequences for the patient and their family. The immune system can be very powerful but it can also be very delicate. It is important that there are measures in place to ensure that the patient is properly protected. This might mean that there are different treatment methods that are considered. If the end result is positive then the patient can be supported.
Infliximab has been part of arthritis treatment programs for a significant period of time. The treatment is sold under the brand name Remicade. They are part of the anti tumor necrosis factor class. In the event they will reduce inflammation and some of the other symptoms that are associated with the condition. You can only be given this medication where the arthritis is active. Under the rules this is a prescription drug that you will get after the approval of a clinician. The administration is through a drip that targets a specified vein. There are over two hours required to complete the infusion of Infliximab. The patient is monitored for two hours to ensure that they are not reacting negatively to the treatment. The patient and their families have to watch out for the side effects which can be devastating if they are not stopped in their tracks.
Responsible usage of Infliximab
It is imperative that you do not take on the medication without the approval of your family doctor. They are in an ideal position to make decisions about your welfare. They will also be able to determine whether any form of treatment is effective in the long run. After the first bout of treatment the doctors will have a cooling off period of about two weeks before they start once again. The infusion will continue on an eight week cycle. The need for a biological therapy card is based on the experiences of people that are responsible for treating patients in an emergency. If you see no response within twelve weeks then it is time for the clinician to look at alternatives. Arthritis is a chronic condition and therefore you should not expect instant results even if you are taking the medication diligently.
Some of the side effects that have been associated with Infliximab included a blocked or runny nose, dizziness, headaches, rashes and stomach pain. It is imperative that these symptoms are addressed as a priority within the context of keeping the patient healthy. In cases where the patient has a serious case of red blood cell deficiency then the intake of Infliximab may make matters worse. That is why a blood test might be required prior to the full prescription. Patients that develop soreness, a cold or paleness should discuss these symptoms with the doctor. It might be that Infliximab is not the ideal treatment at that point in time. There is no point in continuing with the treatment if it is going to make matters worse in the long run. It is far better to look for alternative solutions. Shingles might indicate that the immune system is compromised and the patient needs to look at alternatives.
It is possible to have an allergic reaction to Infliximab. If that is the case then the treatment must be stopped with immediate effect. The signs of an allergic reaction include breathing difficulties and low blood pressure. These are the decisions that need to be taken in order to ensure that the patient’s life is not placed in danger.
Clinical studies indicate that Iloprost is indeed an effective method for treating arthritis. It all depends on the advancement of the condition and the medical advice that is provided by the physician in the case. It is interesting to note that Iloprost is an artificial ingredient that mimics a substance known as prostacyclin. This substance is made naturally in the body and has vasodilator qualities. In effect the substance aids the flow of blood. The prescription for Iloprost will include patients with circulatory problems as well as ulcers in the fingers. Patients with multiple sclerosis might also benefit from this form of treatment depending on the stage at which they are advancing in managing the condition.
The action of Iloprost
It tends to widen the vessels so that blood can travel to all parts of the body. It also reduces the clamping of red blood cells. That means that clotting is managed within the context of the current cardiovascular system. This sort of medication is taken in the form of a drip through the veins. During this time there is an opportunity to monitor the impact of the condition on the body as well as the reaction to the Iloprost treatment. The infusion will be given on a continuous basis for six hours. This will last for five days in a row. The patient may be left on the ward or it could be arranged that they are monitored from their own home. Either way the most important thing is to ensure that the treatment is as effective as possible within the circumstances.
The dosage will be started off at the lower end of the spectrum and then gradually increased until the optimum level is reached. This is a treatment program that requires active participation depending on the way that the patient is using the Iloprost. They have to report if there are any negative reactions so that the clinicians can come up with some alternatives which will help the patient in the long run. The weight of the patient will be an important consideration when deciding the type of dosage that will be applicable in the case. The longer term implications of the treatment have to be taken into consideration. It is important to look out for the signs of hypertension as well as the development of systemic sclerosis. These are conditions which may not be directly associated with arthritis but there is a good case to ensure that there is proper management of the medication regime.
The side effects of Iloprost
Some patients have reported feeling generally sick and others are just experiencing lethargy. If the patient develops a rash, then it is clearly that the Iloprost is having an adverse effect. The clinician should review the medication regime in line with the acceptable standards within the industry. It is this sort of work that will ensure that the patient is protected from some of the more negative aspects of the treatments. Otherwise Iloprost tends to work well against arthritis.
Given the pain that arthritis can give to the patient, it is imperative to use the most effective drugs against it. Hydroxychloroquine has been identified as a great solution for patients. It is sold under the commercial name Plaquenil. It is one of the DMARD drugs that are on the market. The methodology that it uses to handle arthritis is by going to challenge the underlying condition rather than merely concentrating on the symptoms that are displayed during the diagnosis. This is the correct way to handle arthritis without endangering the welfare of the patient.
The prescription process for Hydroxychloroquine
It will be given to patients who are suffering from systemic lupus erythematosus or rheumatoid arthritis. In effect it can help the patient to reduce swelling and pain. You will also get less stiffness in the joints after using the medication. The use of Hydroxychloroquine can help to combat the typical SLE rash. Interesting this same medication is used to treat malaria, a tropical disease that can become fatal if it is not treated properly. The medication is taken in the form of a tablet and the advice is for the patient to take a meal before the medication. It will reduce the corrosive elements of the pill and also avoid some of the side effects.
The clinician that is managing the case will give the patient advice on the correct dosage. The full dose is about four hundred milligrams within two tablets on a daily basis. This dosage can be reduced if the patient is experiencing some relief. If the treatment is very successful then you might not need to take it for more than two times a week. It will be about twelve weeks before you notice a significant change in the progression of the disease. By this time you will already have identified any side effects that are associated with the medication. Patients that have taken this medication have suffered from skin rashes, diarrhea, indigestion, blurred vision and headaches.
Managing the usage of Hydroxychloroquine
There are rare occasions where Hydroxychloroquine might damage the retina. The doctor will be able to adjust the dose in order to get rid of the side effect. Make sure that they are informed right at the beginning so that you do not suffer irreversible damage to your eyes. Doctors sometimes insist on blood tests before prescribing this medication because they do not wish for the patient to develop side effects. An optician may also be required to look at the condition of the eyes prior to the prescription. These are precautions that ensure that you can use Hydroxychloroquine relatively safely. It is not advisable to take this medication whilst breastfeeding because it can pass on to the baby. You also need to ensure that there are arrangements to keep the medication under review. The side effects associated with Hydroxychloroquine can be ferocious and it is imperative that there is medical oversight at all times when you are under this treatment program. In the long run that will help you to keep healthy.
The commercial name for Golimumab is Simponi and it is one of the leading treatments for arthritis. Classified under the anti TNF class or anti tumor necrosis factors, this is one of the most effect ways to deal with other inflammatory diseases. The lists of potential cases that use this treatment include psoriatic arthritis and ankylosing spondylitis. In most cases it is prescribed to adults with any of the conditions. The arthritis has to be active before the prescription will be given. If you are taking another DMARD drug such as hydroxychloroquine or sulfasalazine, then Golimumab will not be prescribed. Patients with psoriatic arthritis will need to first start off with methotrexate before this sort of treatment. Pregnant and breastfeeding women should not take this medication because it could possibly harm the baby. Likewise you should not take Golimumab if you have an infection.
The proper application of Golimumab
A consultant rheumatologist will be able to give you the prescription that you need. The medication is taken through a subcutaneous injection. That means that you can administer it on a DIY basis or train a family member to help you. The injections are given on the thigh or tummy depending on the practicality of the location. The Golimumab that is offered to patients comes in a pre filled syringe or pen of about fifty milligrams. It is given on a monthly basis. A biological therapy alert card may be needed in order to help people that are dealing with an emergency where you are involved. If you forget to take the dosage then you should go back to the plan the moment you remember. The schedule can be reactivated according to the way that you want to take the medication.
The response rate is not instantaneous but quite good when compared to other similar types of medication. You will expect the first positive results within about fourteen weeks of your initial dosage. That is where you will have take about four injections of Golimumab. Where the patient weights more than one hundred kilograms then the doctor may consider increase the dosage slightly. The site of the injection may suffer from redness and swelling. However the more serious reactions happen as a consequence of interference in the immune system. You will be vulnerable to opportunistic infections. That means that you need to take precautions to keep out of harm’s way.
The precautions when you use Golimumab
First of all you will need to watch out for food poisoning. Avoid eating raw foods if you do not know the source of those foods. Make sure that your leftovers are properly refrigerated and that you warm them up to the correct temperature. You might also want to increase the general standards of hygiene within the home in order to reduce the possibility of developing food poisoning in the future. Those are the preventative measures that are expected if you are undergoing a course of Golimumab. It will help you to feel healthier and will reduce the risk of opportunistic infections.
One of the most reliable medical treatments for arthritis is Etanercept. This sort of medication is only available after you have secured a prescription from your family doctor. The method of application is through a subcutaneous injection which is given twice a week. Patients should carry a biological therapy card in case they are involved in an accident. The medication works within twelve weeks. In some fortunate cases the effects will be felt within a matter of two weeks. The basic side effects that are due to this medication include dizziness, headache, a rash, stomach pain and indigestion. The injection site may also become inflamed. The severity of these side effects will directly determine how you respond to the condition in the first place.
Care for patients on Etanercept
There are specific considerations when looking after patients taking Etanercept. First of all the person giving care has to keep a record of major reactions so that the physicians are able to make a correct diagnosis of what is happening. The doctor might wish to have some X-Ray test taken prior to recommending the treatment. They will also want to have blood tests. This drug is sometimes prescribed together with other medication including methotrexate. Doctors have to be aware of all the medication that you are taking so that they can make an informed judgment on the risk of drug interactions.
It has to be understood that Etanercept is not a pain killer and therefore should not be used in that vein. Even where you are merely taking herbal remedies, it is a good idea to consult with your doctor. Some of these remedies can end up making matters worse. The doctor will then explain to you if there are any risks associated with the type of medication that you are taking. Other patients will take Etanercept with Pneumovax. This is a wonderful protective substance against the most common types of pneumonia. It is possible to drink alcohol while you are taking Etanercept. Nonetheless this combination should not be added to methotrexate. This is because interaction can arise and there will be damage to your liver in the long run. Immediately after surgery, the doctor may advise that the intake of Etanercept has to be held back for a while.
Other issues with Etanercept
It is not yet clear whether Etanercept can adversely affect an unborn baby. In the absence of such conclusive evidence, women should be very cautious about the way that they use the product. It is also advisable to keep away from the drug if you are breastfeeding. This is because the drug can pass through the milk to the child’s system. It could be a danger to the child and it is better not to take the risk. The use of Etanercept is primarily focused on arthritis. Nonetheless there has to be some consideration of the personal circumstances of the patient. Nothing should be done to make matters worse. It is imperative that you take the correct dosage of Etanercept according to the prescription.