Introduction
Rheumatoid arthritis is a chronic autoimmune inflammatory disease that is characterized by symmetric degenerative changes in joints such as erythema, effusion, or tenderness, and polyarthritis (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). Typically, the disease affects small joints such as those in wrists, knees, and ankles. The prevalence of the disease is rather small and constitutes about 1% of the world population (Gibofsky, 2014). Women are the most affected population as they are twice as likely to develop this condition (Gibofsky, 2014). The causes of the disease remain unknown. The theories revolve around genetic, environmental, infectious, and other factors. Currently, it is believed that all of the mentioned factors in conjunction serve as the cause.
To confirm the allegations for rheumatoid arthritis experts use an anti-citrullinated protein antibody serology test or measure erythrocyte sedimentation rate. Low-positive and high positive reveal a high chance of confirming the diagnosis. Typical symptoms of rheumatoid arthritis include hour-long joint stiffness in the mornings, pain and/or swelling of joints. Fatigue and weight loss can also be detected. The most common symptom is joint nodules in pressure zones of the body that occur in 15 to 20% of the patients (Arcangelo et al., 2017).
Pharmacotherapeutic Interventions
Pharmacological treatment should be preceded by physical and occupational therapy. These types of treatment may reduce joint stress and help maintain their function. In the early stages of disease progression, the American College of Rheumatology proposed the use of disease-modifying antirheumatic drugs (Smolen et al., 2017). Such therapy is believed to relieve the symptoms and avert the progression of the disease in most cases (Arcangelo et al., 2017).
Nonsteroidal anti-inflammatory drugs and corticosteroids are used only for relieving symptoms while no disease-modifying effects of these drugs were not documented. Disease-modifying antirheumatic drugs such as methotrexate, sulfasalazine, or hydroxychloroquine are usually supported with corticosteroids. The latter provide short-term relief as antirheumatic treatment provides results after several weeks or months. For additional pain relief ibuprofen (short action), aspirin (intermediate action), or nabumetone (long action) could be prescribed. However, they are not recommended for patients who might be allergic to the components of the mentioned drugs. Antirheumatic treatment should be exercised with caution as methotrexate can cause abdominal pain and nausea. In severe cases of side effects, a patient may develop liver toxicity or pneumonitis.
The Impact of Behavior on the Effects of Prescribed Drugs
A patient undergoing antirheumatic disease-modifying treatment should abstain from using alcohol as it is the main cause of severe side effects. Lifting heavy weights with rheumatoid arthritis can also decrease the effectiveness of drug therapy as the degeneration and symptoms will continue to influence the health of joints. In addition, the patient needs to follow the treatment plan without attempts to correct or withdraw from it without notifying the doctor.
Measures to Reduce Negative Side Effects
Dosage is one of the most important issues in the treatment of rheumatoid arthritis. Corticosteroids should only be administered in low dosages as they can cause cataracts and glaucoma (Seegobin et al., 2014). In addition, the patient needs to be advised on using penicillins, tetracyclines, probenecid for comorbidities. Patients should be instructed to report any side effects, as they may be more destructive than helpful.
Conclusion
Rheumatoid arthritis is a serious condition that needs to be treated early. Pharmacotherapeutic interventions can only be effective if administered continuously for a considerable period of time. The negative side effects from symptom-mitigating drugs should be prevented by strict adherence to the dosage and, if they occur, need to be reported and addressed.
References
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins
Gibofsky, A. (2014). Epidemiology, pathophysiology, and diagnosis of rheumatoid arthritis: A synopsis. The American Journal of Managed Care, 20(7), 128-135.
Seegobin, S. D., Ma, M. H., Dahanayake, C., Cope, A. P., Scott, D. L., Lewis, C. M., & Scott, I. C. (2014). ACPA-positive and ACPA-negative rheumatoid arthritis differ in their requirements for combination DMARDs and corticosteroids: Secondary analysis of a randomized controlled trial. Arthritis Research & Therapy, 16(1), R13.
Smolen, J. S., Landewé, R., Bijlsma, J., Burmester, G., Chatzidionysiou, K., Dougados, M.,… Aletaha, D. (2017). EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Annals of the Rheumatic Diseases, 73(3), 510-515.