Arthritis Pain Medication- Understanding Disease-Modifying Anti-Rheumatic Drugs
Disease-Modifying Anti-Rheumatic Drugs (DMARDs) are considered as remissive. This means that they work by slowing down the process of the diseases. As we have first mentioned, the nature of the drugs is not understood yet. They seem to help ease the inflammation while not being anti-inflammatory actually since they do not act by decreasing the release of prostaglandin. Apparently, this group of disease works by altering the immune system in some ways through slowing down the process of the development of the disease.
As expected there were lots of misconceptions on the drugs and many failed to see the real benefits it provide the patient. The effects, duration of use and side effects were all questioned in the early years yet studies were able to surface the commonly unobserved effects and overly emphasized bad results through using DMARDs. Due to the drugs effectiveness and slow acting nature, it is now commonly seen as the second line of treatment against arthritis yet one that gives the long term solution.
Normally, a patient would be prescribed with Disease-Modifying Anti-Rheumatic Drugs if the symptoms of arthritis last for more than six weeks in conjunction to the use of NSAIDs. This combination normally works well for most cases since while the NSAIDs help in the reduction of daily pain, the DMARDs take control of the biological process that drive the inflammation.
The problem though with DMARDs is that it is often hard to calculate the actual dosage that each patient should be prescribed with. This is primarily due to the individual types of arthritis that could be found affecting the bones. Often, it is more like a balancing game where the rheumatologist adjusts the dosage of drugs depending on the observed and actual needs.
Take note that DMARDs are a wide class of medications. However, with each type come individual effects that are proven. The most commonly prescribed DMARDs are gold salts or often termed to as gold therapy, azathioprine, methotrexate, sulfasalazine and chloroquine /hydroxychloroquine.
The history of gold therapy is fairly a product of coincidence. It was first used to treat tuberculosis but results show that in return, it cured arthritis. Anyway, after 50 years it is still yielding much effectiveness on arthritis patients. Like the general perception on DMARDs, the mechanisms that works around the gold therapy is quite not clear yet it seems to interfere with the white blood cells that are in active with the joint damage and joint inflammation.
Hydroxychloroquine, on the other hand, it works by interfering with the functions of the immune system cells.
Methotrexate functions by interfering with the use of the folic acid and with the reduction of the speed of cell growth in the lining of the joints.
Sulfasalazine's real mechanism is not yet known but this drug is often observed with two functions: one is the inhibition of the bacterial growth and the other is through blocking the inflammation process.
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