The document discusses the management of systemic sclerosis. The principle of interventions is to ameliorate the effects of the disease on target organs, as there is no treatment to reverse the fibrotic changes. For Raynaud's phenomenon, calcinosis, and sclerodactyly, pharmacological interventions include calcium channel blockers, prostacyclin infusions, and bosentan, along with lifestyle modifications like avoiding cold and smoking. For esophageal reflux, proton pump inhibitors, anti-reflux agents, antibiotics, and prokinetic drugs are used, along with lifestyle changes. Hypertension is managed with ACE inhibitors and lifestyle modifications. Joint involvement uses analgesics, NSAIDs, and methotrexate, along with

1. MANAGEMENT OF SYSTEMIC SCLEROSIS
Dr. Sami Ur Rehman
Final year MBBS
Quaid-e-Azam Medical College,
Bahawalpur

2. MANAGEMENT OF SYSTEMIC SCLEROSIS:-
Principle of Interventions:-
 “Focus is to ameliorate the effects of disease on
target organs”.
 Because No treatment is there to reverse the
fibrotic changes of the disease.

3. RAYNAUD’S PHENOMENON, CALCINOSIS & SCLERODACTYLY
Pharmacological Interventions
 Calcium channel blockers
 Intermittent infusions of
prostacyclin
 Endothelin-1 antagonist
bosentan
 Antibiotics
Life style modifications
 Avoid exposure to cold
 Use of mittens
 Stop smoking
 Avoidance of
sympathomimetic drugs

4. ESOPHAGEAL REFLEX:-
Pharmacological Interventions
 Proton pump Inhibitors
 Anti-reflux agents
 Anti-biotics
 Metoclopramide/domperid
one
Life style modifications
 Avoid foods that cause gas
 Avoid late night meals
 Elevate the head of your
bed

5. HYPERTENSION
Pharmacological Intervention
 ACE inhibitors
Life style modification
 Stop smoking
 Low-fat diet
 Reduce alcohol and salt
intake

6. JOINT INVOLVEMENT
Pharmacological intervention
 Analgesics
 NSAIDS
 Methotrexate(in case of
synovitis)
Life style modification
 Exercise
 Reduce weight, if
overweight

7. PULMONARY HYPERTENSION
Pharmacological intervention
 Bosentan
 Corticosteroids and cytotoxic
drugs
Surgical intervention
 Heart-Lung
Transplantation