Treatment of rheumatoid arthritis by Dr.Rashid Iqbal MBBS MD

Описание: In this comprehensive Pharmacology lecture, we discuss the Treatment of Rheumatoid Arthritis (RA) in a structured, clinical, and exam-oriented manner.

This topic is highly important for MBBS, BDS, Nursing, Pharmacy, NEET PG, USMLE, and other competitive exams.

🔹 Introduction to Rheumatoid Arthritis

• Definition of RA
• Autoimmune inflammatory joint disease
• Chronic, progressive, systemic involvement

🔹 Normal vs Arthritic Joint

• Normal synovial membrane
• Synovial inflammation in RA
• Pannus formation
• Cartilage destruction
• Joint deformity

🔹 Criteria for Classification

• Clinical features
• Serology (RF, Anti-CCP)
• Acute phase reactants
• Duration of symptoms

🔹 Goals of Management

• Reduce inflammation
• Prevent joint damage
• Preserve joint function
• Improve quality of life
• Achieve remission or low disease activity

🔹 Management of Rheumatoid Arthritis
✅ Non-Pharmacological Management

• Patient education
• Physiotherapy
• Exercise
• Lifestyle modification
• Joint protection

✅ Pharmacological Management
1️⃣ Glucocorticoids

• Used for rapid symptom control
• Bridge therapy
• Anti-inflammatory & immunosuppressive action

2️⃣ DMARDs (Disease Modifying Anti-Rheumatic Drugs)

These are the mainstay of RA treatment.

🔸 Methotrexate

• Drug of choice
• Inhibits folate pathway
• First-line DMARD

🔸 Leflunomide

• Inhibits pyrimidine synthesis
• Alternative to methotrexate

🔸 Cyclosporine

• Calcineurin inhibitor
• Suppresses T-cell activation

🔸 Azathioprine

• Purine synthesis inhibitor
• Immunosuppressant

🔸 Penicillamine

• Older DMARD
• Rarely used due to toxicity

🔸 Hydroxychloroquine

• Antimalarial drug
• Used in mild RA

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📚 This lecture clearly explains:
• Mechanism of joint destruction
• Stepwise management
• Role of steroids
• Importance of DMARDs
• Drug of choice in RA
• High-yield exam points

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