When were NSAIDs first used? Salicylates have been used for centuries. In the 4th century B.C., Hippocrates, Celsus, Galen, and others recorded the use of willow bark and other plants known to contain salicylates to treat fever and pain. Today, one can find numerous health food stores and herbal websites selling willow bark for use …
general properties of NSAIDs NSAIDs are weak organic acids that avidly bind to serum proteins (mainly albumin). The vast majority have low ionization constants (pKa) ranging from 3 to 5, which accounts for their accumulation at inflammation sites such as arthritic joints (inflamed joints often have a lower pH than clinically uninvolved joints). NSAIDs have …
Which antirheumatic drugs are removed by hemodialysis? • Allopurinol—removes 50%. • Azathioprine. • Prednisolone. • Cyclophosphamide—removes 50%. • Tramadol—removes 70%. These drugs should be given after hemodialysis. Other antirheumatic drugs are either not removed by hemodialysis (NSAIDs, narcotics, cyclosporine, methotrexate, leflunomide, colchicine, antimalarials, tacrolimus) or it is unknown if they are.
What dose adjustments are needed for antirheumatic drugs in patients with renal insufficiency? Serum creatinine may be an inaccurate measurement of renal function because as renal function declines, less creatinine is excreted by glomerular filtration and more is excreted by tubular secretion. The use of cimetidine (400 mg four times a day for 2 days) …
How is sarcoidosis treated? Most patients with sarcoidosis do not require therapy. In patients with critical organ involvement, multiorgan disease, or symptoms that significantly affect quality of life, corticosteroids remain the first-line treatment. The exact dosing strategy that balances the desired effect and side effects of corticosteroids is less clear. Oral corticosteroids (up to 1 …
Medical Management of Raynauds Phenomenon Which medications have been useful in the management of Raynauds Phenomenon? All available therapies work better in primary RP than in secondary RP. However, medications beyond CCB are not commonly required for primary RP. Pearl: RP resistant to CCB therapy should prompt consideration of a workup for secondary disease. Medications in …
Treatment for polyarticular subgroup of Juvenile Idiopathic Arthritis Patients with low disease activity at diagnosis are treated with NSAIDs and intraarticular steroids. Patients with moderate to high disease activity at diagnosis are often started on a disease-modifying antirheumatic drug (DMARD), typically methotrexate. Biologics (often TNFα inhibitors) are typically added for refractory disease but may also …
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