Antirheumatic drugs are used to relieve pain in rheumatic diseases. Thus, these drugs and medicines are mainly used to reduce inflammation and for joint diseases.
What are antirheumatic drugs?
Antirheumatic drugs are painkillers that have anti-inflammatory and analgesic effects in rheumatic diseases. In rheumatic diseases, joints and tissues are attacked. Antirheumatic drugs are painkillers that have an anti-inflammatory and analgesic effect in rheumatic diseases. They serve to reduce the symptoms of rheumatism, but have no influence on the causes and further development of the inflammatory disease affecting the joints. Furthermore, antirheumatic drugs act only against the inflammatory, but not against the degenerative rheumatic disease. Although antirheumatic drugs are used primarily for rheumatic diseases, they are also effective for inflammation and pain caused by other diseases and for fever. Rheumatic disease is caused by a dysfunctional immune system that attacks joints and tissues. A cure for rheumatism patients is currently not yet possible. The therapeutic goal is therefore to reduce discomfort, e.g. by taking antirheumatic drugs, and to prevent further joint destruction.
Application, effect, and use
Treatment of the rheumatoid arthritis sufferer should not be limited to the administration of antirheumatic drugs. Especially in the most common rheumatoid arthritis, intensive cooperation between the rheumatologist and, for example, physiotherapists and orthopedists is necessary to ensure the best possible therapy. As a last resort, surgical measures such as the removal of joint mucous membranes and the use of joint prostheses can be considered. The use of antirheumatic drugs provides patients with rapid pain relief, so that their ability to move quickly improves. Unlike non-steroidal anti-inflammatory drugs, steroidal preparations contain cortisone, which can lead to significant side effects. Cortisone-containing antirheumatic drugs should therefore always be used in doses that are as subordinate and cautious as possible. Cortisone-containing antirheumatic drugs can be injected directly into the joints or taken in tablet form. Non-steroidal anti-inflammatory drugs are used for arthritis, inflammation of the vertebrae and gout. They are also used in osteoarthritis (a disease caused by overloading of joints) and soft tissue rheumatism (a painful disease of muscles and musculoskeletal system). A combination of different drugs is often administered in rheumatoid arthritis. In addition to non-steroidal anti-inflammatory drugs, cortisone preparations and herbal agents, these also include the so-called basic drugs, which are intended not only to relieve pain, but also to bring about a reduction in the activity of the disease. However, the exact mode of action of these basic medications supplementing the antihreumatic drugs is not yet known.
Herbal, natural, and pharmaceutical antirheumatic drugs.
Within the group of antirheumatic drugs, preparations can be distinguished according to their material structure:
Chemical-pharmaceutical antirheumatics include the analgesic and anti-inflammatory propionic acid compounds such as ibuprofen, which is used as a non-opioid analgesic for mild to moderate pain. Acetic acid compounds such as aceclofenac have strong anti-inflammatory effects but are less likely to be considered as analgesics. Newly developed are the so-called selective cyclooxygenase-2 inhibitors, which inhibit only one specific enzyme and thus differ from other antirheumatic drugs in their mode of action. In order to reduce the consumption of chemically produced antirheumatic drugs, people like to resort to plant-based active ingredients. The tubers of devil’s claw are used in African medicine to treat pain and fever, among other things. In fact, pharmacological evidence of an anti-arthritic, anti-inflammatory and analgesic effect of this plant has been found. Extracts of devil’s claw caused inhibition of articular cartilage degradation. The prostglandin degradation observed as a side effect with chemically produced antirheumatic drugs did not occur when devil’s claw was used. The use of devil’s claw is particularly suitable for chronic diseases, as the full effect only occurs after three weeks of use. The roots of the comfrey plant have similar effects. Salicylates are based on salicylic acid, which is obtained from willow bark.Because of their sometimes poor tolerability, it is sometimes recommended that medicines based on salicylic acid should only be rubbed in, i.e. only applied externally. The best-known subtype of salicylic acid is acetylsalicylic acid, which has analgesic and antipyretic effects in addition to its anti-inflammatory action. As homeopathic antirheumatics, medicinal herbs are used, for example, as a tea, but also as a poultice, rinse, bath or in ointment form. Homeopathic antirheumatics include essential oils, Schuessler salts, Bach flowers, and remedies according to Hildegard von Bingen.
Risks and side effects
When non-steroidal anti-inflammatory drugs are used, asthma attacks may occur due to bronchoconstriction, as these preparations inhibit the production of prostaglandins, which have a bronchodilating effect. Possible side effects of non-steroidal anti-inflammatory drugs on blood vessels and the heart are still being researched. However, it is suspected that the rheumatic disease itself contributes to secondary cardiovascular problems. The selective cyclooxygenase-2 inhibitors show fewer side effects on gastric mucosa, water excretion and blood clotting. However, the risk of myocardial infarction is thought to increase, especially with initial use of the drug. Antirheumatic drugs containing cortisone can cause side effects such as muscle weakness, osteoporosis, glaucoma (increase in intraocular pressure), clouding of the lens of the eye (cataracts), diabetes, immunodeficiency, and a generally increased risk of infection. Acetylsalicylic acid, derived from willow bark, is thought to increase the risk of gastric bleeding because of its influence on blood clotting. In contrast, devil’s claw and comfrey are reported to be well tolerated and, unlike chemical-pharmaceutical antirheumatic drugs, have no side effects.
