Inflammation

Inflammation, in medicine, reaction of the body to tissue injury or infection. The injured site becomes red and warm because of increased blood flow; swelling and tenderness result from fluids seeping into local tissues, causing increased skin tension. Certain body chemicals involved in inflammation also add to the local pain. Within the inflamed area, special defense cells accumulate, including white blood cells, macrophages, and lymphocytes (see Blood). The white blood cells break down the damaged tissue and signal macrophages; the latter ingest and digest foreign substances and dead tissue (see Immune System). In some diseases this process may be destructive to the host. Treatment depends on the cause.

Treatment: Allopurinol, Analgesic, Aspirin

Nonsteroidal anti-inflammatory drugs: Aspirin, Diclofenac Sodium, Etodolac, Ibuprofen, Ketoprofen, Ketorolac, Nabumetone, Naproxen, Oxaprozin

Steroids: Methylprednisolone, Prednisone, Triamcinolone

Arthroplasty

Many advances have been made in recent years in the design, manufacture, and insertion of new joints, using alloys and sturdy plastics that the body tolerates well. Many patients with diseased hips have achieved greater mobility and relief from pain as a result of hip replacements. Other joints, such as the shoulder, knee, elbow, and ankle also are good candidates for arthroplasty. Flexible silicone joints made in one piece can now be inserted into joints in the hand. These artificial joints are proving useful in treating deformities produced by rheumatoid arthritis and in enabling pain-free movement, particularly in the joints at the base of the fingers.

Naproxen

Naproxen, nonsteroidal anti-inflammatory drug used for relief of pain and inflammation associated with adult and adolescent rheumatoid arthritis, osteoarthritis, ankylosing spondylitis (chronic inflammation of the spine), bursitis, tendinitis, and gout. It is also used in treating headaches and menstrual cramps. Naproxen is an effective painkiller after childbirth, orthopedic surgery, dental treatment, and for strains and sprains. It blocks the production of certain chemicals called prostaglandins that may trigger pain and inflammation.

This drug may be purchased over the counter in tablets of 225 mg. It is available in larger dosages—by prescription only—in tablets of 250 mg, 375 mg, and 500 mg; in sustained-release tablets of 375 mg and 500 mg; and as a liquid, administered orally in 125 mg per 5-ml spoonful. The typical adult oral dosage for rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis is 200 to 500 mg twice a day. For gout, the initial adult dosage is 750 mg followed by 250 mg every eight hours until symptoms disappear. For bursitis, tendinitis, menstrual cramps, and other pain, the initial adult dosage is 500 mg followed by 250 mg every six to eight hours. The total daily dosage should not exceed 1250 mg. For children with rheumatoid arthritis, the dosage is determined on the basis of body weight. Pain relief should begin within one hour, although the full anti-inflammatory effect of this drug may not be apparent for two to four weeks after continuous use.

Naproxen should be taken on a regular schedule, without missing doses. If possible, it should be taken on an empty stomach 30 to 60 minutes before meals or 2 hours after meals. If stomach irritation occurs, it may be taken with food or antacids. To minimize adverse side effects, the lowest effective daily dose should be used. Naproxen should not be used by persons who have had a previous allergic reaction to this drug or an asthmatic reaction to aspirin; pregnant or breast-feeding women; or persons with peptic ulcers or any form of gastrointestinal ulceration or bleeding, bleeding or blood cell disorders, liver disease, or severe impairment of kidney function. It should be used with caution by persons with reduced liver or kidney function. The safety and efficacy of this drug for children under the age of two have not been established. Reduced dosages are advised for persons over the age of 60 until their tolerance of naproxen has been determined. Driving or other risk-related activities should be restricted if drowsiness or dizziness occur with the use of this drug.

Certain mild side effects may occur with naproxen that should disappear as the body adapts to the drug. These include bloating, constipation, diarrhea, difficulty sleeping, dizziness, drowsiness, headache, heartburn, indigestion, lightheadedness, loss of appetite, nausea, nervousness, soreness of the mouth, sweating, or vomiting. More serious but uncommon adverse effects include activation of peptic ulcer disease or ulcerative colitis, bleeding in the stomach or bowel, difficulty breathing, changes in menstruation, and liver or kidney damage. This drug may also cause increased sensitivity to sunlight.

Naproxen may interact adversely with alcoholic beverages and certain other drugs including anticoagulants (blood thinners) such as warfarin; aspirin, salicylates, or other anti-inflammatory drugs; lithium; methotrexate; beta blockers such as acebutolol, atenolol, metoprolol, and timolol; furosemide and thiazide-type diuretics; and probenecid.

Brand Names:Aleve, Naprosyn

Nabumetone

Nabumetone, nonsteroidal anti-inflammatory drug used for relief of pain and inflammation associated with osteoarthritis and rheumatoid arthritis. Nabumetone blocks the production of certain chemicals in the body called prostaglandins that may trigger pain and inflammation.

This drug is available by prescription only. It comes in 500-mg and 700-mg tablets, taken orally. The typical, initial adult dosage is 1000 mg per day. This dosage may be increased as needed and tolerated to 1500 to 2000 mg per day, taken once a day or in divided doses. Relief of symptoms may be felt within one hour, but it may take up to two weeks to feel the full effect of the drug.

Nabumetone should be taken on a regular schedule, without missing doses. It should be taken with food to increase absorption of the drug and to prevent stomach irritation. To minimize adverse side effects, the lowest effective daily dose should be used. Nabumetone should not be used by persons who have had a previous allergic reaction to this drug or an asthmatic reaction to aspirin; pregnant or breast-feeding women; or persons with peptic ulcers or any form of gastrointestinal ulceration or bleeding, bleeding or blood cell disorders, liver disease, or severe impairment of kidney function. It should be used with caution by persons with reduced liver or kidney function and persons taking drugs that reduce blood clotting. The safety and efficacy of this drug for children under the age of 12 have not been established. Reduced dosages are advised for persons over the age of 60 until their tolerance of nabumetone has been determined. Driving or other risk-related activities should be restricted if drowsiness, dizziness, or impaired vision occurs with use of this drug.

Certain mild side effects may occur with nabumetone that should disappear as the body adapts to the drug. These include bloating, constipation, diarrhea, difficulty sleeping, dizziness, drowsiness, headache, heartburn, indigestion, lightheadedness, loss of appetite, nausea, nervousness, soreness of the mouth, sweating, or vomiting. More serious but uncommon side effects include activation of peptic ulcer disease or ulcerative colitis, asthma or difficulty breathing, bleeding in the stomach or duodenum, blurred vision, impairment of normal blood clotting, and liver or kidney damage. This drug may also cause increased sensitivity to sunlight.

Nabumetone may interact adversely with alcoholic beverages and with certain other drugs including anticoagulants (blood thinners) such as warfarin; aspirin, other salicylates, and other anti-inflammatory drugs; beta blockers; diuretics; and probenecid.

Etodolac

Etodolac, drug used to treat osteoarthritis. Etodolac is a nonsteroid, mild analgesic that works by reducing concentrations of certain chemicals in bodily tissues that produce inflammation and pain, relieving swelling and stiffness.

Etodolac is available only by prescription. Capsules or tablets of etodolac are taken orally every six to eight hours, usually in 200 to 400 mg doses. The total daily dosage should not exceed 1200 mg. Capsules should be taken with food and a full glass of water. (Not lying down for 20 to 30 minutes after taking the drug can help avoid stomach upset.) Effectiveness of this drug may not been seen for one to two weeks after beginning treatment.

Patients who experience allergic reactions to aspirin or related medications should not take etodolac. Patients with kidney or liver problems, peptic ulcer, heart disease, or high blood pressure should use this drug with caution. Its safety for use during pregnancy is not known, and it may appear in breast milk. Children under age 12 should not use this drug.

Ulcers or internal bleeding are sometimes caused by this medication. Other possible side effects include abdominal pain, indigestion, nausea, constipation, diarrhea, fever, dizziness, ringing in the ears, or muscle weakness. Occasionally seen are fluid retention, sweating, anemia, fainting, insomnia, rapid heartbeat, skin rash, or yellowing of the skin or eyes.

This drug may interact adversely with aspirin, blood-thinning medications, diuretics, and digoxin.

Brand Name: Lodine