rheumatoid arthritis

Assessment of drug interaction in patients with rheumatoid arthritis” evaluates drug interactions in rheumatoid arthritis patients, focusing on those receiving anti-rheumatic drugs. RA, a chronic autoimmune disorder causing joint and other body parts inflammation, managed with DMARDs, NSAIDs, glucocorticoids, and biologics, with methotrexate being a key treatment component. The study was conducted at the Department of General Medicine, Govt. Medical College Hospital Kozhikode, over four months, enrolling 119 patients who met specific inclusion criteria. The results revealed that drug interactions (DIs) are common among RA patients, particularly those receiving methotrexate. Moderate drug interactions were noted between methotrexate and Leflunomide, Tofacitinib, and sulfasalazine, while minor interactions were observed with Hydroxychloroquine. The study also highlighted frequent interactions between methotrexate and NSAIDs, with meloxicam, Etoricoxib, and Etodolac being the most common interacting drugs. Additionally, interactions between methotrexate and gastro protective agents like pantoprazole and omeprazole were noted. Interactions between methylprednisolone and NSAIDs, as well as between Hydroxychloroquine and hypoglycemic agents, were also identified. Demographically, most patients with drug interactions were in the age group of 40-49 years. Gender-wise, drug interactions were more prevalent among female patients (39.49%). Awareness about drug interactions varied, with middle age groups showed higher levels of awareness. However, a significant portion of the patient population remained unaware of potential drug interactions. To minimize drug interaction, this study suggests possible methods including adjustment of medication timing, prevention of moderate drug interaction by prescribing alternate medications within the same category and prescription auditing with the assistance of pharmacy profession.

The patients who undergo Coronary Artery Bypass Graft surgery or Percutaneous Transluminal Coronary Angioplasty have co-morbid conditions that could negatively influence their survival. Diabetes Mellitus, COPD, Rheumatoid Arthritis, Anxiety and Depression could affect the outcome. Diabetes Mellitus is a risk factor for coronary artery disease. COPD patients could experience pneumonia and atrial fibrillation as complications. Rheumatoid arthritis patients are highly prone to inflammatory process which is the underlying pathology for atherosclerosis and can be a prognostic factor for CAD as well as chances for increased re-occlusion in patients undergoing coronary revascularising procedures. Anxiety and depression are negative emotions that adversely affect the outcome of patients. The co-morbid conditions should be effectively evaluated and managed.