Skip to main content
Canadian Family Physician logoLink to Canadian Family Physician
. 1991 Jan;37:159–167.

Matching the Drug to the Patient

The rational use of antiarthritic drugs

Peter Lee
PMCID: PMC2145138  PMID: 21234089

Abstract

Antirheumatic drugs now available are often effective in helping control the more serious rheumatic disorders, but are not curative. All have potentially serious side effects and need to be used with caution in the presence of recognized risk factors. Treatment should be individualized for the diagnosis and severity of the underlying disease, which must be of sufficient magnitude to justify the risk of potential adverse reactions from the prescribed medication.

Full text

PDF
159

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barrier C. H., Hirschowitz B. I. Controversies in the detection and management of nonsteroidal antiinflammatory drug-induced side effects of the upper gastrointestinal tract. Arthritis Rheum. 1989 Jul;32(7):926–932. [PubMed] [Google Scholar]
  2. Berry H., Swinson D., Jones J., Hamilton E. B. Indomethacin and naproxen suppositories in the treatment of rheumatoid arthritis. Ann Rheum Dis. 1978 Aug;37(4):370–372. doi: 10.1136/ard.37.4.370. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Blackshear J. L., Napier J. S., Davidman M., Stillman M. T. Renal complications of nonsteroidal antiinflammatory drugs: identification and monitoring of those at risk. Semin Arthritis Rheum. 1985 Feb;14(3):163–175. doi: 10.1016/0049-0172(85)90035-6. [DOI] [PubMed] [Google Scholar]
  4. Brater D. C., Anderson S., Baird B., Campbell W. B. Effects of ibuprofen, naproxen, and sulindac on prostaglandins in men. Kidney Int. 1985 Jan;27(1):66–73. doi: 10.1038/ki.1985.11. [DOI] [PubMed] [Google Scholar]
  5. Brogden R. N., Heel R. C., Speight T. M., Avery G. S. Sulindac: a review of its pharmacological properties and therapeutic efficacy in rheumatic diseases. Drugs. 1978 Aug;16(2):97–114. doi: 10.2165/00003495-197816020-00001. [DOI] [PubMed] [Google Scholar]
  6. Brooks P. M., Khong T. K. Flurbiprofen-aspirin interaction: a double-blind crossover study. Curr Med Res Opin. 1977;5(1):53–57. doi: 10.1185/03007997709108977. [DOI] [PubMed] [Google Scholar]
  7. Carmichael J., Shankel S. W. Effects of nonsteroidal anti-inflammatory drugs on prostaglandins and renal function. Am J Med. 1985 Jun;78(6 Pt 1):992–1000. doi: 10.1016/0002-9343(85)90223-2. [DOI] [PubMed] [Google Scholar]
  8. Chalmers J. P., West M. J., Wing L. M., Bune A. J., Graham J. R. Effects of indomethacin, sulindac, naproxen, aspirin, and paracetamol in treated hypertensive patients. Clin Exp Hypertens A. 1984;6(6):1077–1093. doi: 10.3109/10641968409039582. [DOI] [PubMed] [Google Scholar]
  9. Ciabattoni G., Cinotti G. A., Pierucci A., Simonetti B. M., Manzi M., Pugliese F., Barsotti P., Pecci G., Taggi F., Patrono C. Effects of sulindac and ibuprofen in patients with chronic glomerular disease. Evidence for the dependence of renal function on prostacyclin. N Engl J Med. 1984 Feb 2;310(5):279–283. doi: 10.1056/NEJM198402023100502. [DOI] [PubMed] [Google Scholar]
  10. Cowan R. A., Hartnell G. G., Lowdell C. P., Baird I. M., Leak A. M. Metabolic acidosis induced by carbonic anhydrase inhibitors and salicylates in patients with normal renal function. Br Med J (Clin Res Ed) 1984 Aug 11;289(6441):347–348. doi: 10.1136/bmj.289.6441.347. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Croker J. R., Cotton P. B., Boyle A. C., Kinsella P. Cimetidine for peptic ulcer in patients with arthritis. Ann Rheum Dis. 1980 Jun;39(3):275–278. doi: 10.1136/ard.39.3.275. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Dahl S. L., Ward J. R. Pharmacology, clinical efficacy, and adverse effects of piroxicam, a new nonsteroidal anti-inflammatory agent. Pharmacotherapy. 1982 Mar-Apr;2(2):80–90. doi: 10.1002/j.1875-9114.1982.tb03178.x. [DOI] [PubMed] [Google Scholar]
  13. Day R. O., Graham G. G., Champion G. D., Lee E. Anti-rheumatic drug interactions. Clin Rheum Dis. 1984 Aug;10(2):251–275. [PubMed] [Google Scholar]
  14. Ehsanullah R. S., Page M. C., Tildesley G., Wood J. R. Prevention of gastroduodenal damage induced by non-steroidal anti-inflammatory drugs: controlled trial of ranitidine. BMJ. 1988 Oct 22;297(6655):1017–1021. doi: 10.1136/bmj.297.6655.1017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Faulkner G., Prichard P., Somerville K., Langman M. J. Aspirin and bleeding peptic ulcers in the elderly. BMJ. 1988 Nov 19;297(6659):1311–1313. doi: 10.1136/bmj.297.6659.1311. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Gordon G. V., Villanueva T., Schumacher H. R., Gohel V. Autopsy study correlating degree of osteoarthritis, synovitis and evidence of articular calcification. J Rheumatol. 1984 Oct;11(5):681–686. [PubMed] [Google Scholar]
  17. Koopmans P. P., Thien T., Thomas C. M., Van den Berg R. J., Gribnau F. W. The effects of sulindac and indomethacin on the anti-hypertensive and diuretic action of hydrochlorothiazide in patients with mild to moderate essential hypertension. Br J Clin Pharmacol. 1986 Apr;21(4):417–423. doi: 10.1111/j.1365-2125.1986.tb05216.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Lanza F. L., Royer G. L., Jr, Nelson R. S. Endoscopic evaluation of the effects of aspirin, buffered aspirin, and enteric-coated aspirin on gastric and duodenal mucosa. N Engl J Med. 1980 Jul 17;303(3):136–138. doi: 10.1056/NEJM198007173030305. [DOI] [PubMed] [Google Scholar]
  19. Lee P., Anderson J. A., Miller J., Webb J., Buchanan W. W. Evaluation of analgesic action and efficacy of antirheumatic drugs. Study of 10 drugs in 684 patients with rheumatoid arthritis. J Rheumatol. 1976 Sep;3(3):283–294. [PubMed] [Google Scholar]
  20. O'Reilly R. A., Trager W. F., Motley C. H., Howald W. Stereoselective interaction of phenylbutazone with [12C/13C]warfarin pseudoracemates in man. J Clin Invest. 1980 Mar;65(3):746–753. doi: 10.1172/JCI109722. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Ogryzlo M. A., Urowitz M. B., Weber H. M., Houpt J. B. Effects of allopurinol on gouty and non-gouty uric acid nephropathy. Ann Rheum Dis. 1966 Nov;25(6 Suppl):673–680. doi: 10.1136/ard.25.suppl_6.673. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Palmoski M. J., Brandt K. D. Effects of some nonsteroidal antiinflammatory drugs on proteoglycan metabolism and organization in canine articular cartilage. Arthritis Rheum. 1980 Sep;23(9):1010–1020. doi: 10.1002/art.1780230908. [DOI] [PubMed] [Google Scholar]
  23. Palmoski M. J., Brandt K. D. In vivo effect of aspirin on canine osteoarthritic cartilage. Arthritis Rheum. 1983 Aug;26(8):994–1001. doi: 10.1002/art.1780260808. [DOI] [PubMed] [Google Scholar]
  24. Pelletier J. P., Martel-Pelletier J. The therapeutic effects of NSAID and corticosteroids in osteoarthritis: to be or not to be. J Rheumatol. 1989 Mar;16(3):266–269. [PubMed] [Google Scholar]
  25. Pond S. M., Birkett D. J., Wade D. N. Mechanisms of inhibition of tolbutamide metabolism: phenylbutazone, oxyphenbutazone, sulfaphenazole. Clin Pharmacol Ther. 1977 Nov;22(5 Pt 1):573–579. doi: 10.1002/cpt1977225part1573. [DOI] [PubMed] [Google Scholar]
  26. Quattrocchi F. P., Robinson J. D., Curry R. W., Jr, Grieco M. L., Schulman S. G. The effect of ibuprofen on serum digoxin concentrations. Drug Intell Clin Pharm. 1983 Apr;17(4):286–288. doi: 10.1177/106002808301700411. [DOI] [PubMed] [Google Scholar]
  27. Richardson T., Foster J., Mawer G. E. Enhancement by sodium salicylate of the blood glucose lowering effect of chlorpropamide-drug interaction or summation of similar effects? Br J Clin Pharmacol. 1986 Jul;22(1):43–48. doi: 10.1111/j.1365-2125.1986.tb02878.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. SEEGMILLER J. E., GRAYZEL A. I. Use of the newer uricosuric agents in the management of gout. JAMA. 1960 Jul 9;173:1076–1080. doi: 10.1001/jama.1960.03020280016004. [DOI] [PubMed] [Google Scholar]
  29. Semble E. L., Wu W. C. Antiinflammatory drugs and gastric mucosal damage. Semin Arthritis Rheum. 1987 May;16(4):271–286. doi: 10.1016/0049-0172(87)90005-9. [DOI] [PubMed] [Google Scholar]
  30. Sharma B. K., Haslock I. Night medication in rheumatoid arthritis. III. the use of sulindac. Curr Med Res Opin. 1978;5(6):472–475. doi: 10.1185/03007997809111917. [DOI] [PubMed] [Google Scholar]
  31. Silvoso G. R., Ivey K. J., Butt J. H., Lockard O. O., Holt S. D., Sisk C., Baskin W. N., Mackercher P. A., Hewett J. Incidence of gastric lesions in patients with rheumatic disease on chronic aspirin therapy. Ann Intern Med. 1979 Oct;91(4):517–520. doi: 10.7326/0003-4819-91-4-517. [DOI] [PubMed] [Google Scholar]
  32. Singh R. R., Malaviya A. N., Pandey J. N., Guleria J. S. Fatal interaction between methotrexate and naproxen. Lancet. 1986 Jun 14;1(8494):1390–1390. doi: 10.1016/s0140-6736(86)91707-1. [DOI] [PubMed] [Google Scholar]
  33. Sjöberg K. H. Allopurinol therapy of gout with renal complications. Ann Rheum Dis. 1966 Nov;25(6 Suppl):688–690. doi: 10.1136/ard.25.suppl_6.688. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Smyth C. J., Percy J. S. Comparison of indomethacin and phenylbutazone in acute gout. Ann Rheum Dis. 1973 Jul;32(4):351–353. doi: 10.1136/ard.32.4.351. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Sturge R. A., Scott J. T., Hamilton E. B., Liyanage S. P., Dixon A. S., Davies J., Engler C. Multicentre trial of naproxen and phenylbutazone in acute gout. Ann Rheum Dis. 1977 Feb;36(1):80–82. doi: 10.1136/ard.36.1.80. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Verbruggen G., Veys E. M., Malfait A. M., Cochez P., Schatteman L., Wieme N., Heynen G., Broddelez C. Proteoglycan metabolism in tissue cultured human articular cartilage. Influence of piroxicam. J Rheumatol. 1989 Mar;16(3):355–362. [PubMed] [Google Scholar]
  37. Wanasukapunt S., Lertratanakul Y., Rubinstein H. M. Effect of fenoprofen calcium on acute gouty arthritis. Arthritis Rheum. 1976 Sep-Oct;19(5):933–935. doi: 10.1002/art.1780190516. [DOI] [PubMed] [Google Scholar]
  38. Willkens R. F., Case J. B., Huix F. J. The treatment of acute gout with naproxen. J Clin Pharmacol. 1975 Apr;15(4 Pt 2):363–366. doi: 10.1002/j.1552-4604.1975.tb01465.x. [DOI] [PubMed] [Google Scholar]
  39. YU T. F., GUTMAN A. B. Efficacy of colchicine prophylaxis in gout. Prevention of recurrent gouty arthritis over a mean period of five years in 208 gouty subjects. Ann Intern Med. 1961 Aug;55:179–192. doi: 10.7326/0003-4819-55-2-179. [DOI] [PubMed] [Google Scholar]
  40. Ylitalo P., Pitkäjärvi T., Pyykönen M. L., Nurmi A. K., Seppälä E., Vapaatalo H. Inhibition of prostaglandin synthesis by indomethacin interacts with the antihypertensive effect of atenolol. Clin Pharmacol Ther. 1985 Oct;38(4):443–449. doi: 10.1038/clpt.1985.202. [DOI] [PubMed] [Google Scholar]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada

RESOURCES