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From the 2003 Drug Guide
Although arthritis literally means "joint
inflammation," anyone who has one
of the many forms of arthritis and
related conditions knows the condition often
extends far beyond bones and cartilage.
Following are some of the more common
associated conditions and the treatment
for them.
Sjögren's syndrome.
Sjögren's syndrome is
an autoimmune disease in which the body's
immune system attacks its moisture-producing
glands. It often occurs along with other
autoimmune diseases, such as RA, scleroderma
or lupus. For most people, the predominant
symptoms are dry eyes and/or mouth.
Both prescription and OTC drugs can help.
Two oral medications, pilocarpine hydrochloride
(Salagen Tablets) and cevimeline
hydrochloride (Evoxac), are approved for treating dry mouth
associated with Sjögren's. Because both drugs can cause excessive
sweating, it's important to drink plenty of water to avoid
dehydration while using them.
For dry mouth that is less severe, artificial saliva products in the
form of rinses or sprays can help. (Sample OTC brands include:
MouthKote, Optimoist, Oralbalance, Salivant and Salivart.)
Although they are not approved for such, both Salagen and
Evoxac may also help ease dry eyes associated with Sjögren's
syndrome. Artificial tear products, including
Bion Tears, Celluvisc,
GenTeal, HypoTears, Refresh and Tears Naturale, can also ease
dry and gritty-feeling eyes.
Psoriasis.
For people with psoriatic arthritis, scaly patches of
skin (known as psoriatic plaques) accompany joint involvement.
For many people with psoriatic arthritis, both the joint and
skin problems are managed with DMARDs like sulfasalazine
(Azulfidine), injected gold and methotrexate
(Rheumatrex, Trexall).
Strong immune-suppressing drugs such as azathioprine (Imuran)
and cyclosporine (Sandimmune, Neoral) or the biologic agents
etanercept (Enbrel) and infliximab (Remicade).
If these treatments alone don't control the skin problems, doctors
may prescribe some of the following additional medications:
steroid ointments and creams; topical coal tar preparations,
including Tegrin and T-Gel;
calcipotriene (Dovonex), a synthetic
form of vitamin D3 applied topically; tazarotene (Tazorac), a
prescription vitamin A derivative applied topically; etretinate (Tegison)
and Isotretinoin (Accutane), vitamin A derivatives that are taken
orally; anthralin (Drithocreme, Dritho-Scalp, Micanol), a prescription
topical medication; and salicylic acid, an over-the-counter
topical preparation.
A systemic drug called psoralen, along with exposure to ultraviolet
A light, may treat more severe skin involvement.
Irritable bowel syndrome.
By some estimates, as many as 70 percent
of people with fibromyalgia have symptoms of irritable bowel syndrome
(IBS) – abdominal pain and bloating along with constipation
or diarrhea or alternating bouts of the two.
Tegaserod maleate (Zelnorm) recently became the only prescription
drug approved by the FDA to treat the multiple symptoms of
abdominal pain, bloating and constipation associated with IBS.
Earlier, a drug called alosetron hydrochloride (Lotronex) was approved
for treating diarrhea-predominant IBS.
Although Zelnorm and Lotronex are the only drugs approved for
IBS, doctors may prescribe others. Among the most commonly prescribed
are those from a class called anticholinergic (antispasmotic)
drugs, which can reduce the overactivity of the intestine in people
prone to IBS-related diarrhea. These drugs include dicyclomine
(Bentyl, Spasmoban) and hyoscyamine (
Anaspaz, A-Spas S/L, Cytospaz, Donnamar, ED-Spaz, Gastrosed, Levbin, Levsin and Symax SL).
Antiphospholipid antibody syndrome.
People with this autoimmune
condition, often seen in conjunction with lupus, develop antibodies
to the lipid (fatty) membrane of cells and are at risk for
potentially dangerous blood clots. To prevent clots in people with
this condition, doctors may prescribe one of several medications. In
some people, low-dose aspirin reduces clotting risk sufficiently; others
require more potent anticoagulant medications, such as warfarin
(Coumadin) or heparin (Calciparine, Liquaemin).
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