Drugs used to treat muscle and joint disease

Pleuvry, Barbara J.

doi:10.1016/j.mpaic.2008.11.002

« Previous Next »Anaesthesia & intensive care medicine
Volume 10, Issue 1 , Pages 32-34, January 2009

Drugs used to treat muscle and joint disease

Barbara J Pleuvry BPharm, MSc, PhD, is a retired Senior Lecturer in Anaesthesia and Pharmacology at the University of Manchester. She has been involved in teaching pharmacology and neuroscience to undergraduates and postgraduates for more than 40 years. Her research interests included pain, analgesia, and anaesthetic and anticonvulsant drugs. Conflicts of interest: none declared

Abstract

Paracetamol is the first-line treatment for pain relief in patients with osteoarthritis. Non-steroidal anti-inflammatory drugs (NSAIDs) can be used but tend to cause gastrointestinal side effects. The roles of cyclo-oxygenase 2 (COX-2) inhibitors and of drugs aimed at preventing cartilage destruction require evidence from long-term trials. Rheumatoid arthritis may be treated with NSAIDs and glucocorticosteroids, but the early use of disease-modifying anti-rheumatic drugs (DMARDs) is recommended. The pain of gout can be treated with non-salicylate NSAIDs. Alternatives are colchicine and allopurinol. Muscle spasm and spasticity can be treated with GABA_B receptor agonists, such as baclofen, or GABA_A potentiating drugs, such as the benzodiazepines. Peripherally acting drugs such as dantrolene lack central nervous system side effects. Drugs inhibiting the enzyme acetylcholinesterase are used to treat the autoimmune disease myasthenia gravis in which the body produces antibodies to nicotinic receptors for acetylcholine.

Keywords: analgesics, anticholinesterase agents, botulinum toxin, colchicine, gout, multiple sclerosis, muscle relaxants, myasthenia gravis, osteoarthritis, rheumatoid arthritis