ANTI- ARTHRITIS
Arthritis is a painful episodes that mostly happened in our joints,muscles surrounding joints and less likely in all other parts of our body.It is of various types such as Osteo arthritis Rheumatic arthritis and Gout.
Arthritis is mainly due to the inflammation of the affected area.These inflammations are due to the release of various inflammatory agents especially the prostaglandins.Prostaglandins are hormone like secretions by the muscular tissues in response to various stimuli by some events such as injury and acid secretions to express the body language.mostly inflammation
In general inflammation is the reaction of vascularised living tissue to injury.
The main body chemical mediators to initialize the inflammation are known as Prostaglandins.Prostaglandins are localised tissue secretions and are not circulating in the blood.
Prostaglandins are belonging to a group of body chemicals known as ecosanoids as they are mostly prepared by our body from an omega three fatty acid known as ecosatetranoic acid or arachidonic acid.Arachidonic acid is a part of phospholipids present in our body tissues and is released by phospholipase A2.
There are other ecosanoids such as prostacyclines,leucotrienes and thromboxane and evch contribute to form different events of inflammation.A few examples has been given below:-
Prostaglandin E2 (PGE2):- Erythema
Prostaglandin I2 (PGI2) :- Vasodilation
Leucotriene C2 :- edema
Leucotriene D4 :- vasodilation
All of the above :-pain,tenderness
Arthritis of any type has no permanent cure.But the best we can hope is temporary relief.All NSAIDs may give good releif for the inflammatory pains with the excemption of Aspirin during the episodes of Gout due to hyperuricemia as Aspirin is an Anti Uricosuric that means it would block uric acid excretion.Aspirin can be used for any other episodes of Arthritis with caution for GI distress ,bleeding and Ulcers.Not only Aspirin all other NSAIDs have these disadvantages.
Paracetamol can be tried for mild arthritic pains because it is not a perfect anti inflammatory drug but would not disturb the digestive system.Paracetamol in high doses cannot be used as it may harm the liver.
Careless use of NSAIDs can be fatal as in one occation the American FDA released figures of NSAID deaths per year in USA alone was 10000 to 20000 and interestingly these figures were more than the yearly death figures due to illicit drugs like,cocain,marijuana,opium etc.etc.This is mostly because people think that only prescription drugs are harmfull for long time use and not the OTC drugs.This is utter wrong.Even a OTC medicine can be fatal if we use it carelessly.A woman used 15 tablets of Brufen by ignoring the manufacturers warning of not exceed 6 tablets per day.An exhamination for a heavy stomach pain she experienced shown that she damaged her stomach's inner protective linings.Then she pushed back to 10 tablets per day as she thought the manufacture's warning was over cautious.This is utter wrong.
Arthritis of any type has no permanent cure.But the best we can hope is temporary relief.All NSAIDs may give good releif for the inflammatory pains with the excemption of Aspirin during the episodes of Gout due to hyperuricemia as Aspirin is an Anti Uricosuric that means it would block uric acid excretion.Aspirin can be used for any other episodes of Arthritis with caution for GI distress ,bleeding and Ulcers.Not only Aspirin all other NSAIDs have these disadvantages.
Paracetamol can be tried for mild arthritic pains because it is not a perfect anti inflammatory drug but would not disturb the digestive system.Paracetamol in high doses cannot be used as it may harm the liver.
Careless use of NSAIDs can be fatal as in one occation the American FDA released figures of NSAID deaths per year in USA alone was 10000 to 20000 and interestingly these figures were more than the yearly death figures due to illicit drugs like,cocain,marijuana,opium etc.etc.This is mostly because people think that only prescription drugs are harmfull for long time use and not the OTC drugs.This is utter wrong.Even a OTC medicine can be fatal if we use it carelessly.A woman used 15 tablets of Brufen by ignoring the manufacturers warning of not exceed 6 tablets per day.An exhamination for a heavy stomach pain she experienced shown that she damaged her stomach's inner protective linings.Then she pushed back to 10 tablets per day as she thought the manufacture's warning was over cautious.This is utter wrong.
NSAIDs
(NON STEROIDAL ANTI INFLAMMATORY DRUGs):-
-AN OVER VIEW:-
These drugs belongs to a class of dissimilar agents that act by inhibiting the cycloxygenase enzyme and subsquently the synthesis of Prostaglandins.
SALICYLATES
Aspirin
Salsalate
PYRAZOLINES
Phenylbutazone-Extremely toxic can damage blood WBC to produce Agranulocytosis
ACETIC ACIDS
Indomethacin(Indocid)-Can be used in Gout attacks-Cautious to kidneys
Sulindac
Etodolac
Ketorolac-An excellent analgesic
PROPIONIC ACIDS
Ibuprofen (Brufen)
Naproxen
Ketoprofen
OXICAMS
Piroxicam (Feldene)-Longer halflife and hence once daily dose is enough.
FENAMATES
Mefenamic Acid
Meclofenamic Acid
USES
Aspirin differ from other NSAIDs by irriversibly inhibiting cyclooxigenase while others are riversibly inhibiting it.Also Aspirin has antiplatelet activity which last for longer time atleast for 7 days the lifespan of a platelet Aspirin can be very usefull in preventing Myocardial Heart Attacks.
In general NSAIDs are used as an anti inflammatory,Antipyretic,Analgesic and antiplatelet activities.
SLOW ACTING ANTI RHEUMATIC DRUGS (SARDS)
1.Methotrexate
2.Gold salts
3.Penicillamine
4.Hydrochloroquine
These drugs are acting very slowly may take several months for the effects to become real.But it should be warned that a prolonged use may result in serious side effects including a remission of the rheumatic attack.Hence these medicines should be used under doctor's strict supervisions.These medicines should be tried only if the other therapies fail.These are not first line agents.
(To be continued)
