Introduction- What is Etoricoxib?
Etoricoxib, also known as Arcoxia1, is more commonly known as a non-steroidal anti-inflammatory drug (NSAID), or as a cyclo-oxygenase-2 inhibitor (COX-2). Therapeutically, it is specified for the ‘symptomatic relief” of conditions such as osteoarthritis (OA), rheumatoid arthritis (RA), ankylosing spondylitis2,3, and overall for their analgesic and anti-inflammatory properties. Arthritis is a chronic disease affecting up to ten million people in the UK. Approximately 14% of all primary care visits are for musculoskeletal pain or dysfunction, and can be extremely debilitating if not treated in an efficient manner2, 4. However, Etoricoxib is not the first line treatment for arthritis, and doctors are advised to use a standard NSAID such as Ibuprofen initially. Etoricoxib will only be prescribed to patients if other medications have failed to show any effects5.
Recap of the Common Diseases
Osteoarthritis: The most common form of arthritis in the UK. It mainly affects the joint cartilage and the bone tissue next to the cartilage6. It is a localised disease that commonly affects the hip and knee. Normally it is generalised, although it could be secondary to joint disease or other conditions such as obesity or hemochromatosis7.
Rheumatoid Arthritis: A common form of inflammatory arthritis. It is a chronic disease that causes inflammation of joints, pain and loss of function in the joints, as well as inflammation to other body organs. It is an autoimmune condition of unknown origin, where the antibodies are formed against the synovium8.
Ankylosing spondylitis: An inflammatory disease involving the spine and other large joints in the body such as the sacroiliac joint in the pelvis. It has ...
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... the majority of the patients taking Etoricoxib. However, additional recommendations in light of the two patients with incomplete system records would help clarify the indication for the prescription of this specific drug. These include:
1. Clear and comprehensible reasoning in medical notes for the prescription of Etoricoxib with regards to the symptoms exhibited by the patients. This would ensure that repeat prescriptions are justified both with their current GP as well as doctors less familiar with their condition.
2. Regular health check-ups offered by the surgery in order to more closely examine the patients’ response to Etoricoxib as well as any side effects that they might be presenting with. This would allow for better overall patient treatment as well as elucidate the benefits and potential advantages of Etoricoxib over other pain relief medication.
Rheumatoid arthritis is a chronic inflammatory and an autoimmune disease that occurs when the immune system mistakenly attacks the body’s tissue (Rheumatoid arthritis, 2017). This disease affects the entire body, which is called a systemic (means entire body) disease. Arthritis is derived from the word part arthr-, which means “joint,” and -itis, which means “inflammation,” so altogether it means “inflammation of the joints.” It creates inflammation that causes the tissue that lines the inside of joints (synovium) to thicken. About 1.5 million people in the U.S. are affected. It affects all races, but it affects three times as many women than men (What is Rheumatoid Arthritis, n.d.). Overtime, rheumatoid arthritis causes painful swelling that can potentially result in bone erosion or joint deformity, which leads up to physical disabilities. RA can affect more than just your joints, but can spread to body systems, skin, eyes, lungs, heart, blood vessels, e.t.c (Rheumatoid arthritis, 2017).
Osteoarthritis is the most common type of arthritis, it affects millions of people around the world. It is also known as Degenerative Joint Disease or Degenerative Arthritis or Wear & Tear Arthritis. Osteoarthritis occurs when the protective cartilage in the joints wear down over time. While osteoarthritis can affect any joint in your body, it more often is seen in the knees, hips, hands, neck, and lower back it worsens as you grow older and has no known cure.
Osteoarthritis is a degenerative joint condition that primarily affects the hands, spine and the ankles and hips. It is known to be associated with aging, and is concerned with the cartilage that protects the joints (the meeting place of two bones). Normal cartilage allows for bones to slide over each other uniformly, acting as a shock absorber to any damage. However cartilage in osteoarthritis, located at the ends of the bones erodes and deteriorates, causing friction and hence pain, swelling and restricted movement. Therefore in osteoarthritic both the composition and appearance of the cartilage alters, while the body attempts to repair this damaged cartilage is broken down faster than it can be built up. A defective repair process can cause bone overgrowth, bone spur/osteocytes to form which can be seen at the ends of the joints. In osteoarthritis the bones come in close contact with each other, and wear away leaving the bone exposed and unprotected.
Osteoarthritis (OA) is the most common form of arthritis, affecting more than 27 million Americans (LeMone, Burke, Bauldoff, 2011). It is caused when the cartilage in the joints breaks down, causing the bones of the joint to rub against one another. This causes pain, stiffness, and loss of motion in the joint. Osteoarthritis is most prevalent in those 65 and older, but can affect those of any age. In addition, African Americans and Hispanics report a higher incidence of arthritis than Caucasians (LeMone, Burke, Bauldoff, 2011). Although the cause is unknown, it is believed that the increasing age of the population, prevalence of obesity and injuries add to the progression of the condition. Osteoarthritis can affect any joint in the body; however, those of the hand, hip, and knee are often the most common. This condition may be asymptomatic, or may present symptoms including soreness, stiffness and pain. The symptoms are more common in the older population, those with limited activity levels, and those who are obese. Joint cartilage thins over time, causing an increased risk for symptoms in the elderly, and obesity puts extra pressure on the joints during activity. Osteoarthritis is commonly diagnosed with the use of a physical assessment along with results of radiology testing such as X-Ray and MRI.
OA is a musculoskeletal disease that causes chronic joint pain and reduced physical functioning (Laba, brien, Fransen, & jan, 2013). Osteoarthritis (OA) is a non-inflammatory disorder of synovial joints that results in loss of hyaline cartilage and remodeling of surrounding bone. OA is the single most common joint disease, with an estimated prevalence of 60% in men and 70% in women later in life after the age of 65 years, affecting an estimated 40 million people in the United States (Goodman & Fuller, 2009). Women are more commonly affected after the age of 55, almost everyone has some symptoms by the age of 70 (Tan, Zahara, Colburn & Hawkins, 2013, p.78). Osteoarthritis can be described radiological, clinical, or subjective. It commonly affects hands, hips, knees, shoulders, and the spine (Walker, 2011, p. 14). Osteoarthritis is an intrinsic defect in the joint cartilage. Caused by slowly progressive deterioration of articular cartilage that is accompanied by degenerative bony changes, including thickening of the subchondral bone cyst, and formation of large bony protrusions (osteophytes) at the joint margins. Osteoarthritis usually occurs in the large weight bearing joints such as the knees and hips, as well as some of the smaller joints in the hands and feet (Ciccone, 2007,p. 229). ). It is predicted by 2020 to become the fourth leading cause of disability globally (Laba et al., 2013, p.2). According to Juby and Davis (2011), these changing demographics with the aging of the “baby boomer” generation will likely result in an increase in the prevalence of both degenerative and inflammatory arthritis, and timely access to appropriate care and maximization of therapeutic interventions will be vital to maintain indepe...
Osteoarthritis can be known as or sometimes called degenerative joint disease. Osteoarthritis (OA) is a disease that affects not only the old and sick, although 55 and older are most common to be affected, people of all ages may receive osteoarthritis (OA). Approximately 27 million Americans are sharing the same common chronic conditions of the joints.
Arthritis affects people of all age groups. More than 100 types of arthritis are known. Among these osteoarthritis and rheumatoid arthritis having the highest incidence. One of the major causes of chronic debilitation in industrialized nations is Osteoarthritis which results from damage to the joints, which may be due to trauma, infection, or age-related wear. Rheumatoid arthritis is encountered less frequently than osteoarthritis and is estimated to affect around one per cent of the world’s population. Amongst patients of Rheumatoid arthritis, women are three times more likely to be affected by this condition than men. This condition is caused by an inflammatory process where the body starts attacking itself. Rheumatoid arthritis also affects several joints, with inflammation sometimes seen in and around the lungs, the heart, the eyes and the skin. The most commonly reported complaint by arthritis patients is pain. The pain might be from the joint itself and be a result of inflammation, damage from the disease, or through daily wear and tear. Muscle pain is also common and is caused by having to force movements against stiff and painful joints. Although range of movement in the affected joint may be limited and uncomfortable, physical exercise has been shown to benefit those with arthritis. Physical therapy has been shown to significantly improve function, decrease pain in the long term and delay the need for surgery in advanced cases. The majority of arthritis cases occur among theelderly, however the disease can occur in children as well. Over 70% of the population that get affected by arthritis in North America are over the age of 65 (4). The disease occurs more commonly in females than males in all races, age groups, and ethn...
on Pain Care will evaluate the adequacy of pain assessment, treatment, and management; identify and
Rheumatoid Arthritis is when the joints are chronically inflamed, which happens because it is an autoimmune disease which means that the immune system attacks the body tissues. Although Rheumatoid Arthritis mainly affects the joints, it can also affect other organs.
Arthritis is a general term for approximately 100 diseases that produce either INFLAMMATION of connective tissues, particularly in joints, or noninflammatory degeneration of these tissues. The word means "joint inflammation," but because other structures are also affected, the diseases are often called connective tissue diseases. The terms rheumatism and rheumatic diseases are also used. Besides conditions so named, the diseases include gout, lupus erythematosus, ankylosing spondylitis, degenerative joint disease, and many others, among them the more recently identified LYME DISEASE.
Before a person is prescribed this pill, the patient is supposed to undergo a complete physical examination, the patients record should be contained with detailed documentation of the nature and intensity of the pain, current and past treatment, other illnesses, and their history of drug and alcohol use.
This service is experienced, documented, evaluated and paid for as Pharmaceutical Care. Pharmaceutical Care consists of a philosophy of practice, patient care process as well as a patient management system. Pharmaceutical Care has common integrated vocabulary consistent with other patient care practices such as medicine, dentistry and nursing. Philosophy of pharmaceutical care consists of a description of the social need for the practice, a concise and clear statement of individual practitioner responsibilities to meet this social need, the expectation to be patient-centered and the requirement to function within the caring paradigm. This philosophy of practice is expected and practiced by all health care professionals. The patient care processes must be consistent with the patient care processes of all other health care providers. These processes include the assessment of the client’s pharmaceutical needs, a health care plan that is constructed to meet the specific needs of the client and a process in which evaluates the health care plan to gauge the efficacy of decisions made and actions taken. Pharmaceutical care management system includes all resources needed to manage the client’s needs, which include the space provided, such as a clinic or hospital, an appointment system for patients, appropriate and ethical documentation, reporting of patient care, evaluation of decisions made and actions taken and payment of service
A documented patient evaluation, including history and physical examination to establish the diagnosis for which any legend drug is prescribed.
Arthritis affects the hips, knees, spine, hands, lower back, neck, and knuckles. Osteoarthritis spreads throughout the body damaging organs and connective tissue. Osteoarthritis cannot be cured. Physicians seek only to relieve the pain and prevent the patient from becoming disabled. A surgeon may...
Secondly, they advise their patients in assuring the appropriate use of medications. It is important to tell the patient about the name of the drug, what is it for, when to take the drug, how many times per day, whether it should be taken before meals, after meals or with meals, the method of taking the drug and its side effects and possible drug-drug interactions. (Swanson, 2005)