rhuematoid arthritis isA chronic inflammatory disorder affecting many joints, including those in the hands and feet. In rheumatoid arthritis, the body's immune system attacks its own tissue, including joints. In severe cases, it attacks internal organs. Rheumatoid arthritis affects joint linings, causing painful swelling. Over long periods of time, the inflammation associated with rheumatoid arthritis can cause bone erosion and joint deformity. While there's no cure for rheumatoid arthritis, physiotherapy and medication can help slow the disease's progression. Most cases can be managed with a class of medications called anti-rheumatic drugs (DMARDS) Rheumatoid arthritis is an autoimmune condition, which means it's caused by the immune system attacking healthy body tissue. However, it's not yet known what triggers this. Your immune system normally makes antibodies that attack bacteria and viruses, helping to fight infection. Fatigue. Before experiencing any other symptoms, a person with RA may feel extremely tired and lack energy. ... Slight fever. Inflammation associated with RA may cause people to feel unwell and feverish. ... Weight loss. ... Stiffness. ... Joint tenderness. ... Joint pain. ... Joint swelling. ... Joint redness. Rheumatoid arthritis is an autoimmune disease. This means your immune system (which usually fights infection) attacks the cells that line your joints by mistake, making the joints swollen, stiff and painful. Over time, this can damage the joints, cartilage and nearby bone. Lyme Disease. Psoriatic Arthritis. Sjögren's Syndrome. Gout. Fibromyalgia. Lupus.

1. D. PRIYA CHANDANA
VIGNAN PHARMACY COLLEGE
VADLAMUDI

2. DEFINITION :
Rheumatiod arthritis is a chronic
progressive disease causing inflammation in
the joints and resulting in painful deformity
and immobility,especially in the fingers,
wrists,feet and ankles.
 It is a chronic auto immune disease
 It attacks joints with synovial membrane and
tissues
 Along with synovial joint, it also affects extra
articular organs

3.  Genitic factors
 Immunological factors – HLADR14 – effect the
chromosome
 Ciggaratte smoking – greater than 25 yrs
 Accidents / trauma
 Unclear reason
 Menopause
 pregnancy

4. ETIOLOGY, Citration product as an triger
disregulation of immune system
identify the antigen and enters into lymph
nodes

5. activates inflammatory cells CD4 , T cells
activates B cells
convert to plasma cells
release cytokines [ TNF α ][ IL – 1,6]

6. enters into synovial membrane [ synovities ]
inflammation causes
destruction of bone and cartilage
rheumatoid arthrities

7.  Before the weeks , months we identify some
symptoms
 Fever
 Weakness
 Fatigue
 Pain
 Anorexia
 Joint stiffness
 Swelling visual and palpitations

8.  ESR
 RA factor
 C – reactive protein
 Thrombocytopenia
 Normal cytic anemia

9. NON – PHARMACOLOGICAL :
1] REST
2] DECREASE WEIGHT
SURGERIES :
tenocynovectomy
joint repair
joint replacement

10.  Disease modifying anti rheumatoid arthritis
examples : methotrexate , leflunamide ,
hydrochloroquine , sulfasalazine
Rarely : gold salt , cyclosporine , monocycline
1] start with 3 months
2] methotrexate is mostly used IM / ORALLY –
1.7 to 15 mg per week
3] no rapid result
4] to decrease inflammation , slow disease
progression , decreses in motality rate

11. ADRS : bone marrow supression
CI : Pregnancy , lactation
 Biological agents :
anti – TNF agents – entacept , adilimubab
, infliximab
TN – 1 inhibitors – anakinra , rifiximab
expensive
give in the
combination with DMARDS [ METHOTRAXATE]

12. Entacept – sc – 30 mg – once weekly
ADRS : immunodeficiency
 NSAIDS – Examples : aspirin , diclofenac
sodium , naproxen
MTX + Hrochloroquine
MTX + Sulfasalasine
MTX + Leflunamides
MTX + HCQ + Sulfasalasine

13.  If DMARDS [ OR ] ANTI TNF agents did not
work IL – 1 Inhibitors was given
example : 1000 ml – 2 times a week
NSAIDS : symptomatic relief
show faster effect than DMARDS
but doent effect disease progression
CORTICOSTEROIDS ; slow doses – long term
effect prednisolone – 7.5 mg 2 to 3 months