Difference between RA and OA
RA Treatments
Acetaminophen, NSAIDs, Corticosteroids, DMARDS, Biologics, Targeted
... [Show More] DMARDs
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other than ASA, NSAIDs increase risk of having a heart attack or stroke.
Can cause UGI bleed.
May need to take with a PPI
Corticosteroids
Gives quick pain and inflammation relief.
Also slows down your immune system helping control autoimmune diseases
Risks: Glaucoma, cataracts, fluid retention, mood and behavioral changes, hyperlipidemia, hyperglycemia, increased appetite, osteoporosis, thin skin
Traditional DMARDs
suppress the immune system, decreases inflammation, slows down joint damage
DMARDs: Risks
Harder to fight infections,
increase chance of CA
low blood cell counts, diarrhea, HA, hair loss, fatigue, weight loss, stomach upset. Can take several weeks to work. May be prescribed an NSAID
DMARDS: biologic (TNF a antagonist) EIA
Etanercept
Infliximab
Adalimumab
DMARDs-biologic Risks
not available PO, only IV infusions.
Weakens the immune system. (if exposed) TB or Hep B may come back.
May cause HF or MS
DMARDs-biologic Side Effects
HA
injection site reaction
infusion reaction
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starts with transmission
followed by retroviral infection by one of the strains of the HIV-1 and HIV-2
Finally progression of the disease
HIV infects cells that express the CD4 receptor and include:
Macrophages
cD4 T lymphocytes
Langerhans cell of the skill
Macrophages in the CNS
other protected reservoirs, including the intestinal wall
HIV infection is chronic and progressive
1. initially a rapid increase occurs in viral particles in the blood
2. During clinical latency (can be prolonged 10yrs) is low yet still detectable
3. During initial symptoms the viral load increases and the number of CD4s lymphocytes measurable in the blood stream
Therapy Against HIV
1. Combining ART with appropriate management decreases mortality and opportunistic diseases that characterize AIDs
HIV Symptoms
a. flu-like symptoms: fever. chills, fatigue, diffuse erythematous rash
b. serologic tests for HIV may be indeterminant
c. HIV viral load measures are clearly elevated and the CD4 count is within normal range or reduced
d. Often missed clinically because of rapid resolution without the need for acute medical care
Symptomatic HIV Disease
a. often presents similar to acute infection
b. fever, chills, diarrhea, unintended weight loss
c. appearance of non-AIDS-defining infections: shingles, thrush (oral, mucocutaneous, vaginal)
d. Laboratory evidence of HIV viral load
AIDs
a. Measurable immunodeficiency, with the appearance of one AIDs indicator illnesses or opportunistic infections (OIs):
1. pneumocystis Carini
2. cryptosporidium parvum
3. Candidiasis: esophageal bronchial, tracheal, or pulmonary
4. Chronic herpes simplex >1mo
b. CD4 count,200
c. diagnosed in the absence of opportunistic disease
HIV Staging
-Stage 0: inferred from a negative or indeterminate HIV test result w/i 6 months of a confirmed positive result
-Stage 1: CD4 count >500
-Stage 2: CD4 count between 200-500
-Stage 3: CD4 count <200 or a percentage of 14%, or an AIDS defining illness
-Stage unknown: Lab confirmation, no info on CD4 count, percentage, or AIDs defining conditions
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