Dialysis-Related Beta-2m Amyloidosis Medication

Updated: Feb 03, 2017
  • Author: Anita Basu, MD, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Medication

Medication Summary

No medical treatment presently exists to reverse or alter the course of beta-2 amyloidosis. Low-dose steroids and nonsteroidal anti-inflammatory drugs (NSAIDs) are symptomatic approaches to ameliorating joint pain and inflammation. Medications used include the following:

  • Prednisone - Immunosuppressive agent
  • Triamcinolone - Immunosuppressive agent
  • Capsaicin topical -Topical analgesic
  • Ibuprofen -NSAID
  • Sulindac – NSAID
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Immunosuppressants

Class Summary

Used to suppress the inflammatory process.

Prednisone

Prednisone may decrease inflammation by reversing increased capillary permeability and suppressing polymorphonuclear (PMN) leukocyte activity. It is used only in severe cases of joint pain and immobility.

Triamcinolone (Aristospan)

Triamcinolone decreases inflammation by suppressing the migration of PMN leukocytes and reducing capillary permeability. The drug decreases autoimmune reactions, possibly by suppressing key components of the immune system.

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Analgesics, Topical

Class Summary

Topical analgesics penetrate deep for temporary relief of minor, arthritis-associated aches and pains of muscles and joints.

Capsaicin topical (Capzasin-P, Salonpas-Hot, Zostrix)

Capsaicin is derived from plants of the Solanaceae family. It may render skin and joints insensitive to pain by depleting substance P in peripheral sensory neurons.

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Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Class Summary

These agents have analgesic, anti-inflammatory properties and antipyretic activities. Their mechanism of action is not known but may inhibit cyclo-oxygenase activity and prostaglandin synthesis. Other mechanisms may exist as well, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell membrane functions.

Ibuprofen (Advil, Ultraprin, I-Prin, Motrin IB)

Ibuprofen is the drug of choice for patients with mild to moderate pain. It inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

Sulindac (Clinoril)

Sulindac decreases the activity of cyclo-oxygenase and, in turn, inhibits prostaglandin synthesis. Its action results in the decreased formation of inflammatory mediators.

Naproxen (Anaprox, Aleve, Naprosyn, Naprelan)

Naproxen is used for the relief of mild to moderate pain. It inhibits inflammatory reactions and pain by decreasing the activity of the enzyme cyclo-oxygenase (COX), which results in prostaglandin synthesis.

Meloxicam (Mobic)

Meloxicam decreases COX activity, and this, in turn, inhibits prostaglandin synthesis. These effects decrease the formation of inflammatory mediators.

Ketoprofen

Ketoprofen is used for relief of mild to moderate pain and inflammation. Small dosages are indicated initially in small patients, elderly patients, and patients with renal or liver disease. Doses higher than 75 mg do not increase the therapeutic effects. Administer high doses with caution, and closely observe the patient's response.

Flurbiprofen

Flurbiprofen may inhibit COX, thereby, in turn, inhibiting prostaglandin biosynthesis. These effects may result in analgesic, antipyretic, and anti-inflammatory activities.

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