Osteoarthritis (OA) is a degenerative joint disease that affects millions of Americans, primarily in the knees, hips, lower back, neck, fingers, thumbs, and big toe. It is characterized by the gradual breakdown of cartilage, leading to pain, inflammation, and reduced joint function. Diagnosis of OA involves imaging studies, lab tests, and joint fluid analysis to rule out other conditions and confirm the presence of inflammation (Arthritis Foundation, 2018; Mayo Clinic, 2018).
The management of OA focuses on relieving pain, reducing inflammation, and improving joint function. The initial line of treatment for OA involves the use of acetaminophen (Tylenol) at a recommended dose of 650 mg every 4-6 hours, up to a maximum of 4,000 mg in 24 hours. Acetaminophen helps alleviate pain and is generally well-tolerated, but caution should be exercised to avoid exceeding the recommended dose to prevent liver and renal failure (Arcangelo et al., 2017). If acetaminophen is insufficient, non-steroidal anti-inflammatory drugs (NSAIDs) such as diclofenac (Voltaran), ibuprofen (Motrin), or celecoxib (Celebrex) may be prescribed as second-line therapy. These medications help reduce pain and inflammation but can have adverse effects such as dizziness, rash, GI bleeding, and renal impairment. Patients with aspirin allergy, alcohol dependence, or pregnancy should avoid NSAIDs, and caution should be taken with patients who have underlying cardiovascular conditions (Arcangelo et al., 2017).
NURS 6521 Week 6: Osteoarthritis and its Management
Additional pharmacological options for OA management include analgesics like tramadol (Ultram) for pain relief and topical agents such as capsaicin to alleviate symptoms. Corticosteroid injections into affected joints can be considered for patients who do not respond to first and second-line drug therapies. These injections are administered with aseptic technique and may be accompanied by NSAIDs or analgesics to manage injection-related pain (Arcangelo et al., 2017).
Age is a significant factor in the prevalence and management of OA. The risk of OA increases with age, with a higher likelihood of knee, hip, and hand involvement in older individuals. Elderly patients require cautious prescribing of NSAIDs due to the increased risk of adverse effects such as indigestion, ulcers, bleeding, kidney disorders, and exacerbation of hypertension and heart failure. Acetaminophen use should also be monitored in patients with liver disease or those taking warfarin (Arcangelo et al., 2017).
In conclusion, the management of OA involves a multimodal approach that includes pharmacological interventions tailored to the individual’s needs and considerations. Close monitoring of medication use and potential adverse effects, as well as regular follow-up and patient education, are essential for successful management of OA. NURS 6521 Week 6: Osteoarthritis and its Management
References
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.
Arthritis Foundation. (2018). What is Osteoarthritis? Retrieved from https://www.arthritis.org/about-arthritis/types/osteoarthritis/what-is-osteoarthritis.php
Mayo Clinic. (2018). Osteoarthritis. Retrieved from https://www.mayoclinic.org/diseases-conditions/osteoarthritis/symptoms-causes/syc-20351925
