Rheumatoid arthritis is a chronic syndrome that is characterized by inflammation of the peripheral joints, but it may also involve the lungs, heart, blood vessels, and eyes. The prevalence of this autoimmune disease is between 0.3% to 1.5% of the population in the United States (Feinberg, pp 815). It affects women two to three times more often than men, and the onset of RA is usually between 25 and 50 years of age, but it can occur at any age (Reed, pp 584). RA can be diagnosed by establishing the presence of persistent joint pain, swelling in a symmetric distribution, and prolonged morning stiffness. RA usually affects multiple joints, such as the hands, wrists, knees, elbows, feet, shoulders, hips, and small
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The drugs from the first three classes can reduce the number of painful and tender joints, duration of morning stiffness, and indicators of inflammation. NSAIDs are useful for their treatment of RA due to their anti-inflammatory and analgesic actions. These medications will improve mobility and strength, but they will not stop disease progression. DMARDs alter the course of RA, although they do not prevent bone erosion. Methotrexate (Rheumatrex) is the most frequently prescribed drug for the initial treatment of moderate to severe RA. Some other DMARD drugs that are used are Sulfasalazine (Azulfidine), Hydroxychloroquine (Plaquenil), Cyclosporine (Neoral), Azathioprine (Imuran) (Pisetsky, 2792). Among the newest therapies that are being used to treat RA, 'biologics' act on altering the normal immune response by blocking the inflammatory process. These drugs, Etanercept (Enbrel) and Infliximab (Remicade), are administered intravenously and subcutaneously, so that it binds to tumor necrosis factor (TNF), blocking its interaction with cell surface receptors (TNFR). These drugs reduce the signs and symptoms of moderately to severely active RA (Pisetsky, pp 2793).
A person with arthritis may state independence in a given activity but it may be difficult or painful to complete. An individual with RA may experience problems in various areas of living. Self-care is one area in that the patient may be experiencing difficulty, such that the person may be unable to