Osteoarthritis or degenerative joint disease affects 86% of persons over 70 years of age, although symptoms may start in the fifth or sixth decade of life. This common form of arthritis is the result of deformation or mismatched joint surfaces, rather than an inflammatory disease. Symptoms include joint stiffness that usually lasts only a few minutes after initiating movement and perhaps an aching pain in weight-bearing joints. Early disease stages may respond to local heat and nonprescription analgesics. Later stages may require orthopedic or other interventions.
Rheumatoid arthritis usually occurs between 30 to 70 years of age and occurs more often in women than in men. Early symptoms may include feelings of fatigue and weakness, joint pain and stiffness, and, joint swelling several weeks later. Joints are inflamed (warm, red, swollen) and often are limited in range of motion. This is a progressive disease that leads to joint deformity. Aspirin and aspirin-type products (NSAIDs) and Disease Modifying Anti-Rheumatic Drugs (DEMARDs) are usually necessary to reduce the inflammation around the joints and inhibit the progression of the disease. Heat therapy, weight control, and exercise may also be helpful.
A list of drugs utilized in the treatment of arthritis is provided in the Appendix. Detailed tables show doses, recommendations, expectations, side effects, contraindications, and more; available on the book's Web site (see URL in Appendix).
Gout has been called the "disease of Kings" because in the past, royalty ate rich foods and drank wine and alcohol and suffered from gout. However, it is not just for the "rich and famous." Gout is an inflammatory condition that attacks joints, tendons, and other tissues. The most common site of acute gouty inflammation is at the joint of the big toe. It may also be referred to as gouty arthritis. It is characterized by a uric acid metabolism disorder and a defect in purine (products of certain proteins) metabolism, resulting in an increase in urates (uric acid salts) and an accumulation of uric acid (hyperuricemia) or an ineffective clearance of uric acid in the kidneys. Uric acid solubility is poor in acid urine and urate crystals may form, causing urate calculi (stones). Gout may appear as bumps or "tophi" in the subcutaneous tissue of earlobes, elbows, hands, and the base of the large toe. The complications of untreated or prolonged periods of gout include tophi, gouty arthritis, urinary calculi, and gouty nephropathy.
Fluid intake should be increased while taking antigout drugs and the urine should be alkaline. Foods rich in purine, including wine, alcohol, organ meats, sardines, salmon, and gravy should be avoided.
A list of drugs utilized in the treatment of gout is provided in the Appendix. Detailed tables show doses, recommendations, expectations, side effects, contraindications, and more; available on the book's Web site (see URL in Appendix).
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