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.
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.
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 common tricyclic antidepressants is Amitriptyline. Nevertheless it can also be used in the treatment of arthritis or the symptoms of such a condition. It is important that the dosage is controlled because it determines the condition which is targeted. At the higher levels Amitriptyline can be an antidepressant while at the lower levels it is used to manage arthritis. Patients should be mindful of the advice that is given by their family doctor before taking on this type of medication. There can be very serious implications if the medication is taken without proper prescription. It could end up causing long term damage to the patient. For patients with arthritis, this drug can reduce pain and increase the possibility that the patient can sleep. On the other hand it might reduce the anxiety and depression that arthritis patients can suffer from.
The value of Amitriptyline in the treatment of arthritis
Patients who have been referred to a rheumatology pain clinic might be prescribed Amitriptyline in order to reduce the symptoms that they are suffering from. It is normally associated with treating chronic pain. The pain sources could include spinal disorders as well as arthritis. Pain amplification can occur when there is a disconnection with the nervous system. The work of Amitriptyline is to rebalance the chemicals within the nervous system so that the patient ends up feeling less pain in the long run. The medication is available in the form of syrup or tablets. The patient may feely sleepy after taking the medication. Therefore it is best to take this medication just before you go to bed.
The doctor that has prescribed Amitriptyline will be in a position to tell the patient about the maximum dosage. For chronic pain the typical daily dosage is about 5-50 mg per day. The patient will start on a low dose and then work until they are at a pain level which is bearable. The patient should avoid being dependent on the medication on a long term basis because it tends to cause more problems than solutions. Normally the patient will sleep immediately after taking Amitriptyline but the impact on the pain will take a longer period of time. The most common side effect of the medication is a dry mouth. The patient may feel drowsy or disoriented. It is important they do not drive after taking the medication. In some cases the side effects reduce with time.
Other side effects that arise from Amitriptyline
Patients may experience difficulty in passing urine. You may also experience constipation and an irregular heartbeat. If you have high blood pressure then Amitriptyline will make you feel dizzy. This symptom tends to get worse in older patients. Epileptic patients will find that they have an increased number of seizures following the medication. Glaucoma and blurred vision may arise due to the pressure on the eyes. These are rare but very serious symptoms. Therefore you need to arrest them at the earliest opportunity. Your doctor should be involved in the search for solutions.
One of the most common drugs for arthritis is Allopurinol. In technical terms this is known as a xanthine oxidase inhibitor. The body will produce uric acid which is carried through the blood system as urate. The kidneys are responsible for getting rid of this salt through the passage of urine. Too much urate can build up on the joints and cause gout. The intake of Allopurinol will help to reduce the rate at which uric acid is formed in the body. That way that arthritis patient will be given some relief from their symptoms. This medication can be prescribed on a long term basis to prevent the development of gout or to even reduce the symptoms of gout if the patient has already jumped that particular ship.
The prescription of Allopurinol to manage arthritis
Where there is an acute attack of gout then the limitations of Allopurinol are self evident. The primary purpose of the medication is to prevent the accumulation of excess crystals within the body system. Normally the doctor will require blood tests in order to ascertain the development of the condition within the blood stream. Therefore the prescription will be based on facts rather than speculation. It is possible to remove the symptoms of gout or to prevent its progression if you use this medication correctly. The medication is taken in the form of a tablet. Patients are advised to take the Allopurinol tablet once a day and it is preferred that the patient first consumes food before taking the medication. You should swallow the tablet with water.
It is advisable not to take Allopurinol unless any acute attacks have completely settled. The manufactured tablets come in batches with 100 mg and 300 mg strength tablets. A maximum limit of 300 mg is recommended on average although there are cases where the doctor will recommend a higher dosage depending on the reactions of the patient. If the patient is suffering from liver disease or kidney disease then the lower dosage will be recommended for their safety. Surprisingly taking Allopurinol can trigger gout in the first few months before settling down. Therefore doctors might prescribe another form of medication in order to combat these symptoms. In this case NSAIDs are the preferred. One of the branded medications for this purpose is colchicine.
The specific requirements when using allopurinol
If you develop a case of severe gout when using Allopurinol then it is not advisable to stop the medication. You should continue as normal but then treat the symptoms so that the quality of life for the patient is improved in the long run. There will be a significant reduction in the urate levels within the blood after a few weeks of taking the medication. When the crystals are completely dissolved then it is possible to have relief from gout. In some instances it will take a year for the full impact of the treatment to take place. The vast majority of patients do not experience negative side effects when they take Allopurinol. On certain occasions the patient may develop a minor rash. If this becomes serious then medical attention should be sought.
One of the most important courses of medication that may be administered to an arthritis patient is Adalimumab. The brand name for this product is Humira and it is available on a commercial basis. It falls within the category of drugs that are known as anti tumor necrosis factors or TNF. In cases where the patient is suffering from rheumatoid arthritis or RA, there might be an overload of the TNF protein. This will lead to damage within the cartilage, bones and general tissue. The use of Adalimumab can reduce inflammation in general terms but sometimes patients need medication that targets specific symptoms that they are experiencing as part of the progression in the condition. The prescription of Adalimumab is based on the development of rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. Children with idiopathic arthritis or JIA (JCA) may be prescribed this medication.
The use of Adalimumab in practical terms
The arthritis has to be active before the prescription is approved. In cases of RA the doctors will first begin with methotrexate and then progress to DMARD medication. Some of the branded medication may include gold injections and Sulfasalazine. It is only when these forms of treatment are impossible that the doctor will consider the progression to Adalimumab. Women who are pregnant or breastfeeding are not prescribed this medicine because it tends to get into the breast milk and adversely affects the baby. An infection might be a contra indication for Adalimumab. For example ex tuberculosis patients might be excluded. The same rule applies to people with multiple sclerosis. Cancer patients are advised not to take Adalimumab. Likewise people with cardiac problems or lung infections should stay away from the medication.
The medication is only available through prescription on the advice of a rheumatologist. The dosage is about forty milligrams per fortnight. It might be administered through a subcutaneous injection. Where patients are trained or if their families have been instructed, these injections could be administered from home. A district may administer the injections if the immediate is unable to undertake the task. Patients that are on this medication should carry the relevant biological therapy alert card. In that sense, the emergency services will be aware of the existence of another form of medication in your system. The initial responses should occur between two and twelve weeks after starting the course of medication.
Side effects and implications of using Adalimumab
Some patients have reported local reactions near the skin where an injection has been administered. For example they may develop swelling, redness and pain. Nonetheless these symptoms are not serious enough to warrant medical attention. On a far more serious note, the use of Adalimumab might affect the immune system. Therefore the patient may develop infections and it is imperative that the clinician handling the case is informed at the earliest opportunity. If there are serious problems with the administration of Adalimumab then it is imperative that the family doctor is given this information. They can look for better alternatives for the patient.