Orthopedic Medications [3]

Orthopedic doctors often prescribe different medications at the same time. For example, corticosteroids and NSAIDs give relief from pain and inflammation, and DMARDs affect the underlying disease. As with any medication, you and your doctor will need to work together to find the best combination of orthopedic medications for your disease.

Disease-Modifying Antirheumatic Drugs (DMARDs)

DMARDs are primarily used to treat rheumatoid arthritis (RA) and other systemic diseases. Recently, DMARDs (also called slow-acting antirheumatic drugs) have become more widely used. The idea behind using DMARDs is to prevent joint damage. Using more than one DMARD does not seem to cause problems with higher toxicity. However, these drugs do have potential and sometimes serious side effects.

DMARDs can be very effective at slowing the course of certain joint diseases. However, these medications do not cure any disease. Very few patients see their disease go into a complete remission. Most patients find that their symptoms come back after months, or sometimes years, of improvement on DMARDs.

Types and Complications of DMARDs

There are many different types of disease-modifying antirheumatic drugs. Each type has different effects and potential complications. Some DMARDs are used only for specific types of diseases.

Antimalarial Drugs

Hydroxychloroquine and chloroquine have been used since the 1950s for rheumatic diseases. They have been used against malaria for much longer. These drugs are used in the treatment of rheumatoid arthritis and lupus. Chloroquine has more side effects than hydroxychloroquine. Side effects include indigestion, rash, and eye problems. Antimalarial drugs take three to four months to show results for rheumatic diseases.

Penicillamine

This drug affects the way your immune system functions. Almost 25 percent of patients who take it experience bad side effects within the first year. The most common side effects are rashes, blood and protein in the urine, low numbers of platelets in the blood, and autoimmune problems including drug-induced lupus. Taking penicillamine requires regular blood and urine tests.

Sulfasalazine

This fairly new drug is used primarily for the treatment of rheumatoid arthritis and spondyloarthropathies (arthritis of the spine). It may slow down erosions of bone. Almost half of patients develop side effects in the first four months, but most of the reactions are minor. Side effects include rashes, nausea, abdominal pain, liver and blood disorders, low sperm counts, and discolored urine.

Gold

Gold compounds have been used for eighty years to treat rheumatoid arthritis. They are also used in juvenile chronic arthritis and psoriatic arthritis. Gold is injected into your muscles, usually once a week. Most patients only use gold compounds for one to five years. After about a year, most patients stop seeing benefits from using gold therapy. Unwanted side effects include diarrhea, rashes, low levels of platelets and other blood disorders, protein in the urine, lung problems, and sores of the mucous membranes, especially in the mouth.

Methotrexate

Methotrexate shows results in one to two months. Most patients stay on it longer than other DMARDs. In the short term, methotrexate causes nausea, loss of appetite, and high levels of certain liver enzymes. As with all the other DMARDs, there are serious complications with long-term use. It can cause liver damage and lung disease.

Cyclosporine

Cyclosporine can be very effective at slowing the progression of some diseases, but most people who take it develop kidney problems and high blood pressure. Kidney function goes back to normal when you stop taking this disease-modifying antirheumatic drug.