Initial drug prescription in outpatient department: principal approach
https://doi.org/10.14412/1996-7012-2021-3-91-97
Abstract
One of the primary tasks for a doctor when meeting a patient for the first time is to gain his affection and trust. It is not always possible during the first visit to make an accurate diagnosis and prescribe pathogenetic therapy, because this often requires a deep additional examination. However, it is imperative to demonstrate knowledge and confidence, provide psychological support and alleviate the suffering of the patient, especially in the case of rheumatic disease accompanied by severe pain. Such a patient should be immediately prescribed adequate analgesic therapy. The main tool for controlling pain in diseases of the joints and spine are non-steroidal anti-inflammatory drugs. Moreover, their prescription should be deliberate and balanced, taking into account the clinical picture and comorbid pathology.
The article presents two clinical observations, illustrating the formation of a diagnostic and therapeutic concept at an outpatient appointment.
About the Author
A. E. Karateev
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
Andrey Evgenyevich Karateev
34A, Kashirskoe Shosse, Moscow 115522, Russia
References
1. Fowler JB, Khan YR, Fischberg GM, Mahato D. A Cultural Shift Away from Cognitive-behavioral Empathy. Cureus. 2019 Nov 17;11(11):e6175. doi: 10.7759/cureus.6175.
2. Simpkin AL, Armstrong KA. Communicating Uncertainty: a Narrative Review and Framework for Future Research. J Gen Intern Med. 2019 Nov;34(11):2586-91. doi: 10.1007/s11606-019-04860-8. Epub 2019 Jun 13.
3. Hansen E, Zech N. Nocebo Effects and Negative Suggestions in Daily Clinical Practice – Forms, Impact and Approaches to Avoid Them. Front Pharmacol. 2019 Feb 13; 10:77. doi: 10.3389/fphar.2019.00077. eCollection 2019.
4. Nasonov EL, editor. Rossiiskie klinicheskie rekomendatsii. Revmatologiya [Russian clini cal recommendations. Rheumatology]. Moscow: GEOTAR-Media; 2020. 448 p.
5. Martel-Pelletier J, Maheu E, Pelletier JP, et al. A new decision tree for diagnosis of osteoarthritis in primary care: international consensus of experts. Aging Clin Exp Res. 2019 Jan;31(1):19-30. doi: 10.1007/s40520-018-1077-8. Epub 2018 Dec 11.
6. Collins JE, Katz JN, Dervan EE, Losina E. Trajectories and risk profiles of pain in persons with radiographic, symptomatic knee osteoarthritis: data from the osteoarthritis initiative. Osteoarthritis Cartilage. 2014 May; 22(5):622-30. doi: 10.1016/j.joca.2014.03.009. Epub 2014 Mar 21.
7. Törmä lehto S, Aarnio E, Mononen ME, et al. Eight-year trajectories of changes in health-related quality of life in knee osteoarthritis: Data from the Osteoarthritis Initiative (OAI). PLoS One. 2019 Jul 19;14(7): e0219902. doi: 10.1371/journal.pone.0219902. eCollection 2019.
8. Cleveland RJ, Nelson AE, Callahan LF. Knee and hip osteoarthritis as predictors of premature death: a review of the evidence. Clin Exp Rheumatol. Sep-Oct 2019;37 Suppl 120(5):24-30. Epub 2019 Oct 14.
9. Johnson M. Acute knee effusions: a systematic approach to diagnosis. Am Fam Physician. 2000 Apr 15;61(8):2391-400.
10. Jackson JL, O'Malley PG, Kroenke K. Evaluation of acute knee pain in primary care. Ann Intern Med. 2003 Oct 7;139(7): 575-88. doi: 10.7326/0003-4819-139-7-200310070-00010.
11. Davis JT, Rudloff MI. Posttraumatic Arthritis After Intra-Articular Distal Femur and Proximal Tibia Fractures. Orthop Clin North Am. 2019 Oct;50(4):445-59. doi: 10.1016/j.ocl.2019.06.002.
12. Selmi C, Gershwin M. Diagnosis and classification of reactive arthritis. Autoimmun Rev. Apr-May 2014;13(4-5):546-9. doi: 10.1016/j.autrev.2014.01.005. Epub 2014 Jan 10.
13. Cheeti A, Chakraborty RK, Ramphul K. Reactive Arthritis. 2021. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021.
14. Richette P, Bardin T. Gout. Lancet. 2010 Jan 23;375(9711):318-28. doi: 10.1016/S0140-6736(09)60883-7. Epub 2009 Aug 17.
15. Antony A, Tillett W. Diagnosis, classification and assessment. Best Pract Res Clin Rheumatol. 2021 Apr 7;101669. doi: 10.1016/j.berh.2021.101669. Online ahead of print.
16. Momodu II, Savaliya V. Septic Arthritis. 2021. In: StatPearls. Treasure Island: StatPearls Publishing; 2021. https://www.ncbi.nlm.nih.gov/books/NBK538176/
17. Becker BA, Childress MA. Common Foot Problems: Over-the-Counter Treatments and Home Care. Am Fam Physician. 2018 Sep 1; 98(5):298-303.
18. Crawford DC, Hirota MR, Foss EW. MRI of the knee in adults. Instr Course Lect. 2015;64:61-73.
19. Kwiatkowska B, Majdan M, Mastalerz- Migas A, et al. Status of etoricoxib in the treatment of rheumatic diseases. Expert panel opinion. Reumatologia. 2017;55(6):290-7. doi: 10.5114/reum.2017.72626. Epub 2017 Dec 30.
20. Jung SY, Jang EJ, Nam SW, et al. Comparative effectiveness of oral pharmacologic interventions for knee osteoarthritis: A network meta-analysis. Mod Rheumatol. 2018 Nov;28(6):1021-8. doi: 10.1080/14397595.2018.1439694. Epub 2018 Mar 1.
21. Da Costa BR, Reichenbach S, Keller N, et al. Effectiveness of non-steroidal antiinflammatory drugs for the treatment of pain in knee and hip osteoarthritis: a network meta-analysis. Lancet. 2017 Jul 8;390(10090): e21-e33. doi: 10.1016/S0140-6736(17)31744-0.
22. Arendt-Nielsen L, Egsgaard L, Petersen K. Evidence for a central mode of action for etoricoxib (COX-2 inhibitor) in patients with painful knee osteoarthritis. Pain. 2016 Aug; 157(8):1634-1644. doi: 10.1097/j.pain.0000000000000562.
23. Moss P, Benson HAE, Will R, Wright A. Fourteen days of etoricoxib 60 mg improves pain, hyperalgesia and physical function in individuals with knee osteoarthritis: a randomized controlled trial. Osteoarthritis Cartilage. 2017 Nov;25(11):1781-91. doi: 10.1016/j.joca.2017.07.009. Epub 2017 Aug 2.
24. Lin H, Cheng T, Wang J, et al. Etoricoxib improves pain, function and quality of life: results of a real-world effectiveness trial. Int J Rheum Dis. 2010 May;13(2):144-50. doi: 10.1111/j.1756-185X.2010.01468.x.
25. Reginster J, Malmstrom K, Mehta A, et al. Evaluation of the efficacy and safety of etoricoxib compared with naproxen in two, 138-week randomised studies of patients with osteoarthritis. Ann Rheum Dis. 2007 Jul;66(7): 945-51. doi: 10.1136/ard.2006.059162. Epub 2006 Dec 1.
26. Gazeley DJ, Yeturi S, Patel PJ, Rosenthal AK. Erosive osteoarthritis: A systematic analysis of definitions used in the literature. Semin Arthritis Rheum. 2017 Feb;46(4): 395-403. doi: 10.1016/j.semarthrit.2016.08.013. Epub 2016 Aug 24.
27. Marks M, Marks JL. Viral arthritis. Clin Med (Lond). 2016 Apr;16(2):129-34. doi: 10.7861/clinmedicine.16-2-129.
28. Paglia MDG, Silva MT, Lopes LC, et al. Use of corticoids and non-steroidal antiinflammatories in the treatment of rheumatoid arthritis: Systematic review and network meta-analysis. PLoS One. 2021 Apr 7;16(4): e0248866. doi: 10.1371/journal.pone.0248866. eCollection 2021.
29. Feng X, Tian M, Zhang W, Mei H. Gastrointestinal safety of etoricoxib in osteoarthritis and rheumatoid arthritis: A meta-analysis. PLoS One. 2018 Jan 10;13(1): e0190798. doi: 10.1371/journal.pone.0190798. eCollection 2018.
30. Watson D, Bolognese J, Yu C, et al. Use of gastroprotective agents and discontinuations due to dyspepsia with the selective cyclooxygenase-2 inhibitor etoricoxib compared with non-selective NSAIDs. Curr Med Res Opin. 2004 Dec;20(12):1899-908. doi: 10.1185/030079904X12681.
31. Karateev AE, Pogozheva EYu, Filatova ES, Amirdzhanova VN. Endoscopic picture of the upper gastrointestinal tract while taking various non-steroidal anti-inflammatory drugs. Klinicheskaya farmakologiya i terapiya. 2018; 27(4):40-5. (In Russ.).
32. Curtis SP, Ng J, Yu Q, et al. Renal effects of etoricoxib and comparator nonsteroidal anti-inflammatory drugs in controlled clinical trials. Clin Ther. 2004 Jan;26(1):70-83. doi: 10.1016/s0149-2918(04)90007-0.
33. Martin Arias LH, Martin Gonzalez A, Sanz Fadrique R, Vazquez ES. Cardiovascular Risk of Nonsteroidal Anti-inflammatory Drugs and Classical and Selective Cyclooxygenase- 2 Inhibitors: A Meta-analysis of Observational Studies. J Clin Pharmacol. 2019 Jan;59(1):55-73. doi: 10.1002/jcph.1302. Epub 2018 Sep 11.
Review
For citations:
Karateev AE. Initial drug prescription in outpatient department: principal approach. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2021;15(3):91-97. (In Russ.) https://doi.org/10.14412/1996-7012-2021-3-91-97
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