Reactive Arthritis Medication

  • Author: Carlos J Lozada, MD; Chief Editor: Herbert S Diamond, MD   more...
 
Updated: Mar 27, 2012
 

Medication Summary

The goals of pharmacotherapy are to reduce morbidity, to prevent joint damage, and to alleviate extra-articular disease.

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Nonsteroidal anti-inflammatory drugs (NSAIDs)

Class Summary

Several NSAIDs are available and have similar effectiveness, although indomethacin may be more effective in the spondyloarthropathies. These agents are used to treat symptoms. Cyclooxygenase-2 (COX-2)–specific inhibitors can be used in patients at high risk for GI complications.

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Ibuprofen (Motrin, Advil)

 

Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

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Indomethacin (Indocin, Indochron E-R)

 

Rapidly absorbed. Metabolism occurs in liver by demethylation, deacetylation, and glucuronide conjugation. Inhibits prostaglandin synthesis.

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Tetracyclines

Class Summary

These agents are used to treat urethritis or cervicitis caused by chlamydial organisms. Some evidence shows that, in chlamydia-induced ReA, tetracycline treatment may reduce duration and perhaps severity of illness. Collagenase inhibitors have been used to treat early rheumatoid arthritis.

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Doxycycline (Bio-Tab, Vibramycin)

 

Inhibits protein synthesis and, thus, bacterial growth by binding to 30S and possibly 50S ribosomal subunits of susceptible bacteria.

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Corticosteroids

Class Summary

These agents have anti-inflammatory properties and cause profound and varied metabolic effects. Corticosteroids modify the body's immune response to diverse stimuli.

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Prednisone (Sterapred)

 

May decrease inflammation by reversing increased capillary permeability and suppressing PMN activity.

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Aminosalicylic acid derivatives

Class Summary

These agents are used to reduce inflammation.

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Sulfasalazine (Azulfidine, EN-tabs)

 

Acts locally in colon to decrease the inflammatory response and systemically inhibits prostaglandin synthesis.

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Contributor Information and Disclosures
Author

Carlos J Lozada, MD  Director of Rheumatology Fellowship Program, Professor, Department of Medicine, Division of Rheumatology and Immunology, University of Miami, Leonard M Miller School of Medicine

Carlos J Lozada, MD is a member of the following medical societies: American College of Physicians and American College of Rheumatology

Disclosure: Pfizer Honoraria Speaking and teaching; Amgen Honoraria Speaking and teaching

Coauthor(s)

Maria F Carpintero, MD  Fellow, Department of Rheumatology, University of Miami, Jackson Memorial Medical Center, Miami Veterans Affairs Medical Center

Maria F Carpintero, MD is a member of the following medical societies: American College of Physicians and American College of Rheumatology

Disclosure: Nothing to disclose.

Specialty Editor Board

John Varga, MD  Professor, Department of Internal Medicine, Division of Rheumatology, Northwestern University

John Varga, MD is a member of the following medical societies: American College of Physicians, American College of Rheumatology, Central Society for Clinical Research, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Elliot Goldberg, MD  Dean of the Western Pennsylvania Clinical Campus, Professor, Department of Medicine, Temple University School of Medicine

Elliot Goldberg, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, and American College of Rheumatology

Disclosure: Nothing to disclose.

Alex J Mechaber, MD, FACP  Senior Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine

Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Chief Editor

Herbert S Diamond, MD  Adjunct Professor of Medicine, Division of Rheumatology, University of Pittsburgh School of Medicine; Chairman Emeritus, Department of Internal Medicine, Western Pennsylvania Hospital

Herbert S Diamond, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Rheumatology, American Medical Association, and Phi Beta Kappa

Disclosure: Merck Ownership interest Other; Smith Kline Ownership interest Other; Zimmer Ownership interest Other

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