Medical Today

Pharmacology.

Leflunomide’s active metabolite (M1) inhibits dihydro-oratate dehydrogenase, thereby inhibiting pyrimidine biosynthesis. M1 exhibits immunomodulating and anti-inflammatory effects.

Administration and Adult Dosage.

PO for rheumatoid arthritis 100 mg/day for 3 days, then 20 mg/day. Reduce dose to 10 mg if 20 mg is not tolerated.

Pediatric Dosage.

Safety and efficacy not established.

Geriatric Dosage.

Same as adult dosage.

Dosage Forms.

Pharmacology.

Infliximab is a chimeric monoclonal antibody that binds to soluble and transmembrane forms of TNF a, thereby neutralizing the activity of TNFa and inhibiting TNFa binding to its receptor sites. It has no effect on lymphotoxin (TNFa).Infliximab induces pro-inflammatory cytokines including interleukins 1 and 6 and increases endothelial cell permeability by enhancing leukocyte migration.

Administration and Adult Dosage.

Description

Neck pain is a nonspecific symptom of discomfort that has a number of possible causes. Depending on the cause, neck pain may be experienced as limited to the neck itself (localized), or as radiating to the shoulders and upper arm. The patient may experience the pain as a dull ache, a sharp stabbing or burning sensation, or a feeling resembling a muscle cramp. Neck pain is often accompanied by stiffness or difficulty in moving the neck.

Pharmacology.
Aspirin is an analgesic, antipyretic, and anti-inflammatory agent. Anti-inflammatory properties are related to the inhibition of prostaglandin biosynthesis. Aspirin nonselectively inhibits cyclo-oxygenase-1 (COX-1), which is associated with GI and renal effects and inhibition of platelet aggregation, and cyclooxygenase-2 (COX-2), which is associated with the inflammatory response.
Unlike other NSAIDs, its antiplatelet effect is irreversible and permanent (because of transacetylation of platelet COX) for the life of the platelet (8-11 days). Salicylates without acetyl groups (eg, sodium salicylate) have essentially no antiplatelet effect but retain analgesic, antipyretic, and anti-inflammatory activities. Low dosages (1-2 g/day) decrease urate excretion; high dosages (>5 g/day) induce uricosuria.

The word ‘arthritis’ means ‘inflammation of joints’. It comes from two Greek words, athron meaning joints and its meaning inflammation. It is a chronic disease process. In the early stages, the whole body is usually involved and one or two joints may become completely deformed, leaving the patient handicapped and somewhat weakened.

Arthritis assumes various forms, the most frequent being osteoarthritis and rheumatoid arthritis. Inflammation is the main feature of arthritis, which is a reaction of the joint tissues to some form of damage or injury.