Once this type of disease is diagnosed, it cannot be cured! If you take medicine for a long time, you must pay attention to this!

When it comes to rheumatic and immune diseases, everyone can think of systemic lupus erythematosus, rheumatoid arthritis, Sjögren's syndrome, ankylosing spondylitis...

01

What is rheumatism?

Rheumatic autoimmune diseases, referred to as rheumatism, are a group of musculoskeletal system diseases, including diffuse connective tissue diseases and diseases of joints and peri-articular soft tissues caused by various causes.

Well-known ones include: rheumatoid arthritis, systemic lupus erythematosus, primary Sjögren's syndrome, ankylosing spondylitis, dermatomyositis, gout, etc.

At present, the cause of rheumatism is still unclear, and it cannot be completely cured clinically. It is a chronic disease and is even called "immortal cancer";

The vast majority of patients need long-term use of drugs such as "hormones", "immunosuppressants" and "biological agents" to control their condition, and most have a good prognosis.

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In the treatment of rheumatic diseases, the following types of drugs are often involved:

Such as glucocorticoids, immunosuppressants, biological agents, anti-inflammatory analgesics, etc., the rational use of these drugs can not only effectively control the disease, but also save the patient's life in critical moments;

However, long-term use of these drugs may cause some adverse reactions due to their unique pharmacological mechanisms and immunosuppressive effects while exerting their effectiveness.

When rheumatologists give patients these drugs, they usually remind them repeatedly how to use the drugs properly and ensure regular follow-up visits.

Because in addition to the complexity of the disease, the safety of drug use must also be monitored at all times.

During the diagnosis and treatment process, clinicians will naturally monitor and deal with common adverse drug reactions. But in some cases, even experienced doctors will be troubled.

02

How to use medicine for rheumatic autoimmunity?

1. It combines multiple diseases in one, and requires a wide variety of medications!

Doctor, I have rheumatoid arthritis and I have to take 5-6 kinds of medicine every day;

In addition, I also have high blood pressure, diabetes, coronary heart disease, and high blood lipids. I have to take more than 10 kinds of medicine every day. When I wake up every morning, I feel like a "medicine jar". After taking the medicine, I feel that I am "70% full".

Every time I come to the hospital for a follow-up check, I am terrified. Doctor, I know I have to take all these medicines, and many of them cannot be stopped, but I want to know which medicines cannot be taken together, and what I need to pay attention to when taking them?

I’m afraid that if I continue eating like this, my liver and kidneys will be damaged!

The patient's underlying diseases are complex and he or she has multiple other diseases. Each disease requires multiple drugs to control the condition. Are there any adverse reactions between the multiple drugs and whether there are any incompatibilities between the drugs?

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2. The usage of the drug is complicated!

Doctor, I have systemic lupus erythematosus and have been taking "prednisone, hydroxychloroquine, tacrolimus" and other drugs. I read the instructions for these drugs and felt "very scary". Some drugs need to be taken with meals, some need to be taken in the morning, some need regular eye examinations, some need to check drug concentrations, and some drugs need to be avoided...

I don't have any professional education, so how can I remember so many complicated things? Can you just tell me how to take these medicines in a simple way?

The treatment methods of some patients are complicated. For example, some drugs require genetic testing before use, some drugs require monitoring of drug concentration during treatment, whether there are dietary restrictions when taking the drugs, the time of taking the drugs, whether the drugs need to be taken on an empty stomach, etc.

3. How to use medication during pregnancy and lactation?

Doctor, I have "takayasu arteritis" and have been taking medicine. Now my condition is under control and stable. My wife and I want to have a child. I want to know if the medicines I am taking now can be taken during pregnancy, whether they will have a big impact on the child, and whether I can breastfeed in the future?

How should special populations, such as patients with fertility needs (including men), use medications? Is it safe for women with rheumatic diseases to use medications during pregnancy? How to adjust? How to use medications during breastfeeding?

4. How do middle-aged and elderly people and those suffering from special diseases use medications?

Doctor, my mother is over 70 years old. She had a lung tumor before and is now taking targeted drugs. Her kidneys are not good either and she has been on dialysis for a long time. Recently, she was diagnosed with Sjögren's syndrome. I would like to ask if taking these immune-regulating drugs will have any effect on her tumor? Will it have any effect on her kidneys?

For special populations, especially elderly patients, and patients with special diseases such as tumors, hepatitis B, and kidney disease (requiring hemodialysis), how should they choose drugs when they have combined rheumatic diseases?

03

Do not reduce or stop taking medication without authorization

For example, glucocorticoids are the most familiar to everyone. Many patients are afraid of hormones when it comes to hormone treatment. Long-term use of large doses of hormones may cause adverse reactions such as increased blood pressure, increased blood sugar, obesity, and osteoporosis.

However, the rational use of hormones can greatly alleviate the patient's condition and improve the patient's prognosis. As the condition stabilizes and some preventive drugs are used during hormone treatment, the adverse reactions of hormones can be minimized as much as possible.

Therefore, when patients with rheumatic diseases need to take hormone treatment, they must follow the rheumatologist's instructions and must not reduce the dosage or even stop taking hormones on their own!

In addition, there are immunosuppressive drugs and biological agents, which mainly inhibit the function of immune cells in the body, block inflammatory signaling pathways, regulate immunity and inhibit inflammation, and are indispensable drugs for the treatment of rheumatic diseases.

However, during medication, it is also necessary to evaluate whether there are any contraindications to the medication and closely monitor adverse reactions.

Source: Run Run Shaw Hospital

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