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Combination Therapy DMARDs Dietary implications
- High fish oil and certain fatty acid diet better
- Foods with antioxidant properties (fruits, vegetables)
- Bad
- ----Meat/ protein
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Osteoarthritis
- Most common joint disease
- Caused by defect in joint cartilage (not autoimmune)
- Slow deterioration of articular cartilage, degenerative change in bone, thickening of subchrondral cone, creation of subchrondral bone cysts, formation of large bony protrusions (osteophytes)
- Occurs in large weight bearing joints
- Drugs help manage pain and maintain active lifestyle
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DMOADs
- Viscosupplementation
- Glucosamine and chondroitin sulfate
- Acetaminophen
- NSAIDs
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Viscosupplementation
- Improve viscosity and function of synovial fluid
- Injected into arthritic joint
- Reduces stresses, limits progression of disease
- Reduces pain 6mo – yr after injections
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Glucosamine and chondroitin sulfate
- Protect articular cartilage and halt/reverse degeneration of OA
- Key ingredients in production of components of articular cartilage and synovial fluid
- Function
- ----Repair joint tissue
- ----Improve viscosity
- ----Help restore joint function
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Acetaminophen
- Often first drug used to treat OA
- ---- Safe for long term use
- Controls pain and doesn’t have GI side effect
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NSAIDs
- Used for symptomatic treatment of pain in OA, don’t alter course of disease
- Used for analgesics effects
- Anti-inflammatory effect can help control mild Synovitis in advances OA (due to joint destruction)
- COX-2 cause less GI disorders but increase risk of CV disease
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Therapist Considerations
- Decreased pain and inflammation allowing more active and vigorous exercise and functional activities
- Some medications halt the destruction of the disease allowing for the restoration of muscle strength and joint function rather than just maintenance of disease
- Impact of meds on therapy sessions
- ---Joint pain and swelling may occur due to medications
- --------Methotrexate
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