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Miscellaneous Drugs during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Gold salts are immunosuppressants in humoral and cell-mediated mechanisms, act as antirheumatic agents, and cross the placenta (Gimovsky and Montoro, 1991). Conception should be delayed one to two months after cessation of therapy in patients taking gold compounds. Fetal exposure to gold compounds has adverse neonatal renal and hemolytic effects.
Therapeutic Application of Monoclonal Antibodies in the Rheumatic Diseases
Published in Thomas F. Kresina, Monoclonal Antibodies, Cytokines, and Arthritis, 2020
The therapeutic use of MAbs in cancer and organ transplantation, as well as in animal models of autoimmune disease, has provided background for the potential utility of both murine and human MAbs in the management of patients with rheumatic disorders. The remainder of this chapter reviews the currently available evidence and future directions for the role of MAbs as antirheumatic agents in specific diseases.
Haematology
Published in Michael McGhee, A Guide to Laboratory Investigations, 2019
Neutropenia (neutrophils <1 × 109/l) may be due to: infections (e.g. bacterial/viral tuberculosis (TB), typhoid, brucellosis, rickettsia and malaria)autoimmune disorders, e.g. RA, SLEhaematological disorders, e.g. leukaemia, myelodysplasia, myeloma, lymphoma, vitamin B12 or folate deficiencydrugs (e.g. antibacterial drugs (e.g. penicillin, cephalosprins, doxycycline, trimethoprim, metronidazole), analgesics (e.g. aspirin, indomethacin, ibuprofen), psychiatric drugs (e.g. chlorpromazine, risperidone, chlordiazepoxide, mianserin), anticonvulsants (e.g. phenytoin, sodium valproate, carbamazepine), cytotoxic therapy, some antirheumatic agents (especially gold), cardiovascular drugs (e.g. propranolol, nifedipine, captopril, spironolactone), thiazide diuretics and many others, including colchicine, allopurinol, metoclopramide and carbimazole).When referring routinely for a non-urgent haematolgy opinion (neutrophils <1 in a well patient), request antinuclear antibodies (ANA), LDH, B12 and folate and protein electrophoresis.
Amyloid A amyloidosis in a patient with Caplan’s syndrome, with special reference to genetic predisposition
Published in Modern Rheumatology Case Reports, 2020
Tadashi Nakamura, Naoki Shiraishi, Yasuhiro Morikami, Hiromi Fujii, Takeshi Yoshinaga
Although TCZ is reportedly preferred to other antirheumatic agents to treat AA amyloidosis in RA [26], the efficacy of this agent for our patient continued for just 2 years (Figure 4). The frequency of AA amyloidosis has been decreasing because of remarkable developments in RA therapy [27], but we in clinical practice often encounter difficult-to-treat patients with AA amyloidosis who have less inflammatory surrogate markers but who do have AA amyloidosis symptoms. Thus, AA amyloidosis, one of the most severe complications of RA, is a difficult-to-manage condition [28]. If an early therapeutic intervention to the underlying inflammatory diseases were not performed, organ functions might reach points of no return despite advanced RA treatments. We frequently see RA patients at the terminal stage of AA amyloidosis in their first referrals, that is, patients who lack high-quality rheumatologic medical health services like the present case. We should thus strive to improve medical care and opportunities for healthier lives for these patients.
LDL cholesterol is associated with systemic vascular resistance and wave reflection in subjects naive to cardiovascular drugs
Published in Blood Pressure, 2019
Manoj Kumar Choudhary, Arttu Eräranta, Antti J. Tikkakoski, Jenni Koskela, Elina J. Hautaniemi, Mika Kähönen, Jukka Mustonen, Ilkka Pörsti
Altogether 230 (37.4%) of the 615 persons used some medications. Seventy-six females were treated with systemic oestrogen, progestin, or their combination (contraception, hormone replacement therapy), and 1 subject with tibolone. Forty-one subjects were treated with antidepressants, 18 with antihistamines, 17 with inhaled corticosteroids, 13 with proton pump inhibitors, while 22 euthyroid subjects were on a stable dose of thyroid hormone. Other medications in use were hypnotics or sedatives (8), low dose acetylsalicylic acid (6), non-steroidal anti-inflammatory drugs (4), antirheumatic agents (4), antiepileptics (3), allopurinol (3), coxibs (3), antipsychotics (2), muscle relaxants (2), varenicline (2), antiviral agents (2), paracetamol (1), carbimazole (1), isotretinoin (1), and alendronate (1). One subject was treated with warfarin because of an anti-phospholipid syndrome, and she was physically well and symptomless during the recordings.
Gel network comprising UV crosslinked PLGA-b-PEG-MA nanoparticles for ibuprofen topical delivery
Published in Pharmaceutical Development and Technology, 2019
Ipek Eroglu, Merve Gultekinoglu, Cem Bayram, Acelya Erikci, Samiye Yabanoglu Ciftci, Eda Ayse Aksoy, Kezban Ulubayram
Even though the management of RA has changed considerably over the past years, treatment of RA is still unsatisfactory and the patients often receive personalised/tailored treatments based on the clinical stage of the disease. These treatment options generally include pain relief and anti-inflammatory strategies (Ward 1984). Three main classes of drugs that are commonly used to treat RA are analgesics, anti-inflammatory drugs and antirheumatic agents (Ward 1984). Initial treatment usually involves the administration of disease modifying antirheumatic agents (DMARDs) (responsible for slowing the progression of joint damage and maintaining relief) in combination with a non-steroidal anti-inflammatory drug or a low dose corticosteroid. However, side effects such as the suppression of wound healing and also the susceptibility of patients to bacterial infections after orthopedic surgery (such as total joint arthroplasty, reconstructive surgeries, or cervical stabilization) were found to be associated with this treatment modality. Notwithstanding the significant improvement achieved in the last decade with regards to these types of surgical techniques, the risk of infection due to suppression of wound healing (associated with the use of immunosuppressants in the treatment of RA) still remains challenging. To avoid such infections, there is a need for rapid clinical improvement in the symptoms of RA (Scanzello et al. 2006; Mushtaq et al. 2011; Goodman and Paget 2012). Treatment of RA has been revolutionized by the development and approval of the biological DMARDs such as infliximab, adalimumab, tocilizumab, etc. Nevertheless, these promising strategies still face certain drawbacks such as treatment failure, drug’s partial response and unwanted side effects (Batheja et al. 2011; Abioye et al. 2015).