A Pharmacological Look At Rhumatoid Arthritis
E.S. is a 68-year-old Caucasian female who has been diagnosed with rheumatoid arthritis. According to Stedman’s Medical Dictionary for the Health Professions and Nursing, “rheumatoid arthritis (RA) is a systemic disease, that more often occurs in women than in men, which affects connective tissue” (Stedman, 2005, p. 1276). She has had this rheumatic disease for the past 15 years. As would be expected with RA, her symptoms and pain have progressively gotten worse over that period of time. The disease has affected both the joints in her hands and the joints in her knees, but her hands are where the majority of her pain stems from. She is the main person of her household, meaning that she does all of the cleaning, cooking and shopping for her family. Having RA has made it extremely difficult for her to continue her activities of daily living. Management of her symptoms, pain and inflammation, can be done with some success by the medications she has been prescribed. Teaching her home management of these drugs will increase the effectiveness of their actions and greatly increase her activities of daily living.
Pathophysiology
According to Gunta and Rizzo (2007),
“the actual disease process in rheumatoid arthritis is initiated by an autoimmune response in which the cells of the body turn and fight against themselves. The inflammatory response follows, setting into otion a chain of events that perpetuates the condition. As the inflammatory process progresses, the synovial cells and subsynovial tissues undergo reactive hyperplasia. This causes vasodilatation and increased blood flow to the affected joint causing warmth and redness. The result of the increased capillary permeability that accompanies the inflammatory process is the joint swelling that occurs. An extensive network of new blood vessels develop in the synovial membrane which contributes to the advancement of the disease. This vascular tissue is called pannus which is a feature of RA...
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