Arthritis Q&A
October 30, 2001 | 12:00am
Q1. If I have arthritis, what kind of doctor should I seek help?
Rheumatologists are internists specialized in the conservative treatment of musculoskeletal diseases. They diagnose and classify your type of arthritis; prescribe medicines that stop the pain and disease progression; they do some minor procedures such as aspiration of excess fluid from an inflamed joint; they tell you what to expect depending on what type of arthritis you have and discuss the consequences that are associated with your problems; they monitor complications that may arise from the disease itself or from drug therapy; and, they help you improve your quality of life the medical way.
Q2. Why do some doctors keep on prescribing expensive medicines when there are cheaper drugs available?
The older generation pain relievers are known as non-steroidal anti-inflammatory drugs (NSAIDs). They are potent analgesics and are oftentimes can be acquired through over-the-counter purchase and they are the common drugs purchased by self-medicating arthritic patients. However, these drugs are not without side effects. The most common problems associated with NSAIDs are gastrointestinal (GI) discomfort, gastric ulcer and bleeding. A large number of patients here and abroad died of massive gastrointestinal bleeding.
The new generation pain relievers known as COX-2 specific inhibitors (Coxibs) are less toxic and are associated with lesser incidence of gastrointestinal bleeding. For example, rofecoxib, a COX-2 specific inhibitor, decreases incidence of GI bleeding by more than 50% (VIGOR Study).
The peso value of COX-2 specific inhibitors may be a little more expensive, however, it reduces the "indirect cost" of medical treatment. By indirect cost, we mean the antacid, the endoscopy (documentation and treatment of GI bleed), the blood transfusion, the hospital confinement, and rescue surgery in case bleeding is very massive.
The leave of absence; the family emotional and physical burdens; all of these are indirect costs that we have to pay for in lieu of the little peso difference. Isn’t it worthwhile to prescribe COX-2 specific inhibitors?
Dr. Perry P. Tan is a rheumatologist, founder and head of the Rayuma Klinik of Jose R. Reyes Memorial Medical Center (JRRMMC) and consultant at St. Luke’s Medical Center.
Rheumatologists are internists specialized in the conservative treatment of musculoskeletal diseases. They diagnose and classify your type of arthritis; prescribe medicines that stop the pain and disease progression; they do some minor procedures such as aspiration of excess fluid from an inflamed joint; they tell you what to expect depending on what type of arthritis you have and discuss the consequences that are associated with your problems; they monitor complications that may arise from the disease itself or from drug therapy; and, they help you improve your quality of life the medical way.
Q2. Why do some doctors keep on prescribing expensive medicines when there are cheaper drugs available?
The older generation pain relievers are known as non-steroidal anti-inflammatory drugs (NSAIDs). They are potent analgesics and are oftentimes can be acquired through over-the-counter purchase and they are the common drugs purchased by self-medicating arthritic patients. However, these drugs are not without side effects. The most common problems associated with NSAIDs are gastrointestinal (GI) discomfort, gastric ulcer and bleeding. A large number of patients here and abroad died of massive gastrointestinal bleeding.
The new generation pain relievers known as COX-2 specific inhibitors (Coxibs) are less toxic and are associated with lesser incidence of gastrointestinal bleeding. For example, rofecoxib, a COX-2 specific inhibitor, decreases incidence of GI bleeding by more than 50% (VIGOR Study).
The peso value of COX-2 specific inhibitors may be a little more expensive, however, it reduces the "indirect cost" of medical treatment. By indirect cost, we mean the antacid, the endoscopy (documentation and treatment of GI bleed), the blood transfusion, the hospital confinement, and rescue surgery in case bleeding is very massive.
The leave of absence; the family emotional and physical burdens; all of these are indirect costs that we have to pay for in lieu of the little peso difference. Isn’t it worthwhile to prescribe COX-2 specific inhibitors?
Dr. Perry P. Tan is a rheumatologist, founder and head of the Rayuma Klinik of Jose R. Reyes Memorial Medical Center (JRRMMC) and consultant at St. Luke’s Medical Center.
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