Rheumatoid arthritis.pptx

Rheumatoid arthritis

1. RH E UMA T O I D ARTHRITIS Dr. Ajith JS Asst. Professor Department of Pharmacology Sanjivani College of Pharmaceutical Education & Research, Kopargaon

2. INTRODUCTION ▹ Rheumatoid arthritis (RA) is an autoimmune disease that can cause joint pain and damage throughout the body ▹ The joint damage that RA causes usually happens on both sides of the body

3. PATHOPHYSOLOGY T riggering factors ( MHC, STAT) Increase infla mm a t o r y mediators Release B- cells T- cell activation Auto immune T-cell Proliferation of T cell

4. SYMPTOMS The main symptoms of rheumatoid arthritis are: ▹ Joint pain ▹ Joint swelling, warmth and redness ▹ Stiffness, especially first thing in the morning or after sitting still for a long time. Other symptoms can include: ▹ Tiredness and lack of energy – this can be known as fatigue ▹ Weight loss ▹ A high temperature, or a fever ▹ Sweating ▹ Dry eyes – as a result of inflammation ▹ Chest pain – as a result of inflammation. ▹

5. RISK FACTORS Exposure to certain types of bacteria Having a history of viral infections Smoking cigarettes ▹ Sex ▹ Having a family history of RA ▹ ▹ ▹ ▹ Having obesity

6. COMPLICATIONS Effects on the Skin Eye Complications Pain in the Neck Heart and Blood Vessel Disease Blood Disease Lung Problems Infections

7. DIGNOSIS Physical examination Examining joint function and range of motion Touching the affected joints to check for warmth and tenderness ▹ Looking for swelling and redness ▹ ▹ ▹ Testing your reflexes and muscle strength

8. Blood test ▹ Rheumatoid factor test ▹ Anticitrullinated protein antibody test ▹ Anti nuclear antibody test ▹ Erythrocyte sedimentation rate ▹ C-reactive protein test. DAS 28

9. N o n p har m a co l o g i c a l t re atment ▹ Physiotherapy ▹ P h y s i c a l a c ti v i ty ▹ Hydrotherapy ▹ F o ot c a r e TREATMENT NICE guideline Draft for consultation, January 2018Rheumatoid arthritis in adults: management [Internet], cited on 22 Aug 2020; Available from; https://www.nice.org.uk/guidance/ng100/documents/draft-guideline Daniel Aletaha, Tuhina Neogi, Alan J. Silman,2010 Rheumatoid Arthritis diagnosis Criteria An American College of Rheumatology/European League Against Rheumatism [Internet], cited on 22 Aug 2020;Available from; https://www.rheumatology.org/Portals/0/Files/2010_revised_ diagnostic criteria ra.pdf JASVINDER A. SINGH, KENNETH G. SAAG 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis[Internet], cited on 22 Aug 2020;Available from; https://www.rheumatology.org/Portals/0/Files/ACR%202015%20RA%20Guideline . Aneela Mian , Fowzia Ibrahim and David L. Scott A systematic review of guidelines for managing rheumatoid arthritis [Internet], cited on 22 Aug 2020;Available from; https://bmcrheumatol.biomedcentral.com/track/pdf/10.1186/s41927-019-0090-7

10. Ph a r m a c ologi c a l t re a t m e n t ▹ First-line treatment for RA was disease-modifying anti-rheumatic drug (DMARD) Eg, T. Methotrexate 7.5 mg once a week T. Leflonumide 10 mg OD ( second line DMARD) ▹ NSAIDs Eg, T. Ibuprofen 200mg TID T. Naproxen 250mg BD ▹ Biological agents Eg, Inj .Tocilizumab 4mg/kg IV once in a month and 162mg SC once in a w ee k Inj .Infliximab 3mg/kg IV once in every 2 weeks ▹ Corticosteroids E g , T. Pr e dn i s o l o n e 5 - 6 m g O D