Managing Rheumatoid Arthritis: Prescription drugs, home care, and considerations during pregnancy
In the battle against Rheumatoid Arthritis (RA), various treatments are available, each with its unique benefits and potential side effects.
Home interventions play a crucial role in preventing RA complications. Maintaining a moderate weight and avoiding high blood pressure are key factors in reducing joint stress, pain, and joint damage.
When it comes to medications, three main classes are commonly used: Synthetic Disease-Modifying Anti-Rheumatic Drugs (DMARDs), Biological DMARDs, and Targeted Synthetic DMARDs.
Synthetic DMARDs, such as Methotrexate (MTX) and Sulfasalazine, are often the first line of defence. MTX intolerance is common, with nausea (85.5%) being the most frequent side effect. Sulfasalazine may cause gastrointestinal distress and respiratory issues.
Biological DMARDs, like Tocilizumab/Actemra and TNF inhibitors, are known for their immune-related effects, gastrointestinal symptoms, and injection site reactions. Serious infections, due to immune suppression, are a significant concern, and cardiovascular risks are associated with some agents.
Targeted Synthetic DMARDs, such as Janus kinase (JAK) inhibitors, are linked to dyslipidemia, thrombotic risk, and require individualized cardiovascular risk assessment.
Surgery is usually a last resort for RA and is only advised for stage 4, or end-stage RA.
Corticosteroids, while stronger than Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), can cause side effects such as osteoporosis, diabetes, weight gain, and suppression of the immune system. In some cases, they can be injected into the painful joint by a doctor.
Lifestyle changes are also crucial in managing RA. Regular physical activity, such as low-impact exercises like tai chi, yoga, and swimming, can improve symptoms. Maintaining a moderate weight and BMI is essential, and certain dietary choices, like diets rich in fish oils, omega-3 oils, cumin, calcium, vitamin D, and folic acid, could potentially alleviate symptoms.
It's important to note that some medications for RA can cause complications during pregnancy, affecting the pregnant individual, the child, or both. Therefore, careful consideration and consultation with a healthcare provider are necessary.
Physical and occupational therapy can also significantly improve RA symptoms.
In summary, while each treatment option comes with its set of side effects, understanding them is the first step towards effective management of RA. Home interventions, lifestyle changes, and regular medical check-ups are vital components of a comprehensive RA management plan. Always consult with a healthcare provider for personalised advice.
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