RHEUMATOID ARTHRITIS

Presented by: Supervisor:

Ankush Bhushan Ms. Parveen Bagga
8th sem Lecturer, Pharmacology
(Regd. No.
7103251233 )
GURU NANAK COLLEGE OF PHARMACY, DALEWAL, PUNJAB, INDIA.
2011
Rheumatoid arthritis is chronic , systematic,
autoimmune disorder in which Immune system
identifies the synovial membrane as "foreign" and
begins attacking it.
Despite intensive research over many decades, the
cause of RA remains unknown.
Three areas of interrelated research are currently most
promising:
1. Host genetic factors,
2. Immunoregulatory abnormalities and autoimmunity,
and
3. A triggering or persisting microbial infection.
Stage 1: Synovitis.
 Inflammatory cell deposition.
 Painful, swollen, tender joints.

Stage 2: Destruction.

Chronic synovitis

Proteolytic enzymes pannus Synovial hyperplasia

Articular cartilage destructiion

Stage 3: Deformity.

Deformity

Joint destruction Tendon Rupture Capsular stretching

1. Muscle weakness
2. Muscle pain
3. Joints pain
4. Pain on motion
5. Tenderness
6. Swelling in joints
7. Early morning stiffness.
1. Morning stiffness.
2. Arthritis of 3 or more areas.
3. Arthritis of hand joints.
4. Symmetrical Arthritis.
5. Rheumatoid Nodules.
6. Rheumatoid Factor.
7. Radiological changes.
{4 of the 7 for at least 6 weeks}
Blood tests
Rasied ESR.
C-reactive Protein.
Serological test
Rheumatoid factor.
Anti CCP.
Synovial fluid Analysis
Raised WBC.
Mucin test.
Radiography of Hand and Feet
 Treatment

Primary goal is to relieve pain and inflamation.

Prevent joint destruction.
Improve Patient functional ability.
Correct deformed joint.
To maintain patient normal life style.
Drug Therapy
First Line Drug- NSAIDs.
Second Line Drug- DMARDs.
Third Line Drug- Immunomodulators.
Corticosteroids.

Physiotherapy
Preserve joint mobility & function.

Splints
Prevent & correct deformities.
Prior to Surgery
STOP:
Salycilates – 2 Wk prior to surgery.
NSAIDS – 5 Days prior to surgery.
If corticosteroids taken for more than 3 Wks in
previous 12months, it should be given in pre, intra &
post operative period.