MEDICAL INSIDER
DR CORA LIM
FOR MAY 21, 2023
Applied Rheumatology Made Simple (A.R.M.S.)
(Part 8 )
Our first focus now is on Anti-inflammatory Drug Therapy
NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs)-I.
What are these? These are about the the widely used drugs for
various conditions with pain and Inflammation; the only drug that
may be required by the patient; and the different patients and
diseases responses to various NSAIDs
Talking about the Anti-inflammatory Drug Therapy
NONSTEROIDAL ANTIINFLAMMATORY DRUGS (NSAIDs)-II,
we refer these to the use of one NSAID at a time and a note for
possible drug interactions e.g. antihypertensives, warfarin
Through decades of NSAID use, the most commonly reported
side-effect has been gastropathy. It has been established that
specific COX-2 inhibitors or coxibs have the singular advantage of
producing minimal to nil GI side-effects.
What is Celecoxib? It is the first coxib introduced into the market,
followed by rofecoxib. Soon, there will be other coxibs, with
slightly varying indications and routes of administration. Despite
their specific COX-2 -related mechanism of action, there may be
some differences in effects and side-effects related to the
individual drugs.
Talking about Anti-inflammatory Drug Therapy
CORTICOSTEROIDS-I, we have to note the following: Anti-
inflammatory activity directly correlates with dosage; Adrenal
suppression directly correlates with dosage, duration, frequency
and schedule of administration; and Chronic side effects include
Cushing’s, osteoporosis, AVN, cataract, hyperglycemia, infections
etc. But if we talk about Anti-inflammatory Drug Therapy
CORTICOSTEROIDS-II, we have to note the following: Determine
minimum effective dose to control signs and symptoms; Steroids
may be abruptly discontinued within 5 to 7 days of administration
and If steroid history is unclear, do not abruptly discontinue
steroids
What are some of the ARTHRITIS-RASH SYNDROMES “HELP-
LINES”? We have Internal Medicine, Rheumatology,Nephrology,
Dermatology, Hematology, and others.
(TO BE CONTINUED)