Question

B. Mr. Farrell is a 78-year-old white male patient who comes to your office complaining of increased left knee pain for the past 3to 4 months. He has had no history of recent injury. An X-ray done less than 4 months ago showed degenerative osteoarthritic changes. He has full range of motion and denies any recent swelling, pedal edema, or discoloration. He has been a long-distance runner for many years and was diagnosed with osteoarthritis of his left knee more than 10 years ago. He has decreased his weekly running, but the pain is persistent and is affecting his daily activities. He has been using over-the-counter NSAIDs on and off, but states they are no longer working and wants something "stronger." His vital signs are all normal and he has had no history of fever, chills, and or rashes. He is otherwise healthy. 1. How would you approach the management of chronic pain in this patient?

patho of the disease, medication of choice,patho of the the medication, side effects, and patient education

Answer 1

Ans) The osteoarthritis(OA) is one kind of joint disease that can come due to aging or due to any other kind of wear and tear on the bone junctions.This is distinguished by the failure and the dropping of a joint cartilage , excessive growth of bone and changes in the ligaments.

According to the records we can say that almost 27 million adults in the US and most of the people after the age of 26 are facing the difficulties with OA. But still in US and other countries the rate of people with OA is increasing.And we can say that the 2 of each 3 obse adults is having the high chance of developing the OA.In case of men it usually start to occur before the age of 45 and usually in women it starts to occur after the age of 45.And also every reports are saying that 1 in each 2 people will be having the OA after the age of 85.These are major things that a patient should be known about their OA disease.

The pathogenesis of the OA include a degradation of the cartilage and changing the structure of bone because of the effective reply of chondrocytes in the articular cartilage and the swelling cells in the nearby tissues.The leaving of these enzymes from these cells make the collagen and proteoglycans  failure and also the crash the articular cartilage.And the subjection of the subchondral bone results in a sclerosis,which is followed by the effective changes in the structure of bone and which leads to the making of osteophytes and also the subchondral bone cysts.And what happens is that the bone gap is continuously lost over the time.

Some of the medications for this disease are,

Non steroidal anti-inflammatory drug- Helps to reduce the inflammation and also to decrease the fever.And some of the side effects are stomach ulcers, liver and kidney problems and also the High blood pressure.

Analgesic- Reduce the pain in the joint.And the side effects are constipation, skin itching ,Ringing in your ears and Dizziness.

Narcotic- Helps in weakening the sense and reduce the pain.Side effects are Nausea, vomiting, Addiction and Abdominal pain

Duloxetine.- Side effects are Fatigue, Loss of appetite, Constipation and Sleepiness.

THANKS!!!!