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Allergen: A substance that triggers an allergic reaction.

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Allergic Rhinitis: An allergy affecting the mucus membrane of the nose. Seasonal allergic rhinitis is often called "hay fever."

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Allergist: A doctor that diagnoses, treats, and manages allergy-related conditions.

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Ana-Kit: A device used to inject epinephrine during an anaphylaxis attack.

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Anaphylaxis: A life-threatening allergic reaction that involves the entire body. Anaphylaxis may result in shock or death, and thus requires immediate medical attention

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Animal dander: The small scales or pieces of skin, often containing proteins secreted by oil glands, which are shed by an animal. These proteins are the major causes of allergies to pets.

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Antibiotics: A class of medications used to treat bacterial infections. Certain antibiotics, such as penicillin, may cause an allergic reaction in some people.

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Antibody: A protein in the immune system that recognizes and attacks foreign substances in the body.

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Anticonvulsant: A medication used to prevent or treat seizures. Certain anticonvulsants may cause an allergic reaction in some people.

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Antihistamines: A class of medications used to block the action of histamines in the body and prevent the symptoms of an allergic reaction.

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Asthma: An inflammatory disorder of the airways, causing periodic attacks of wheezing, coughing, chest tightness, and shortness of breath.

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Atopic dermatitis: A chronic skin rash, also known as "eczema," that often appears in the first few years of life.

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Basophil: An immune system cell that attaches to antibodies and circulates through out the blood.

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Beta-blockers: A class of blood pressure medications that ease the heart's pumping action and widen the blood vessels. Beta-blockers counteract the effects of epinephrine used for emergency treatment of anaphylactic shock and should not be used during immunotherapy.

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Bronchial tubes: The lower sections of the airway that lead into the lungs.

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Challenge test: A test used to confirm an allergy to specific substance. A doctor will administer small but increasing amounts of a suspected allergen until an allergic response is noticed. Due to the risk of anaphylaxis, this should only be performed under a controlled setting.

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Conjunctivitis: Inflammation of the conjunctiva, or the mucous membrane surrounding the eye. Also known as pinkeye.

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Contact dermatitis: An allergic reaction resulting from skin contact to an allergen.

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Corticosteroid: An anti-inflammatory medication used to treat the itching and swelling associated with some allergic reactions.

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Cromolym sodium: An anti-inflammatory nasal spray used to treat and sometimes prevent allergic rhinitis.

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Decongestants: A class of medications used for nasal congestion. Decongestants are available in oral doses, nasal sprays, or eye drops (for conjunctivitis).

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Dust mites: A microscopic organism that lives in dust.

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Eczema: See Atopic dermatitis.

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Eosinophil: A specific type of immune cell that can cause tissue damage in the late phase of an allergic reaction.

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Epinepherine: A medication used for immediate treatment of anaphylaxis by raising blood pressure and heart rate back to normal levels. Epinepherine is also known as adrenaline.

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EpiPen: A device used to inject epinephrine during an anaphylaxis attack.

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Heparin: A chemical released by basophils and mast cells that causes nearby tissues to become swollen and inflamed.

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Histamine: A chemical released by basophils and mast cells that causes nearby tissues to become swollen and inflamed.

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Hives: See urticaria.

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Hypertension: High blood pressure. When blood pushes against artery walls harder than normal.

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Immunoglobulin E: A type of antibody responsible for most allergic reactions.

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Immunotherapy: A series of shots that help build up the immune system's tolerance to an allergen.

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Insulin: A hormone that regulates blood sugar levels. Diabetics who take insulin derived from animals may have allergic reactions.

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Intradermal test: A test where an allergen is injected just underneath the skin. Intradermal tests are generally used when results from a skin prick test are unclear.

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Late Phase: The period 4 - 24 hours after exposure to an allergen where tissue damage may occur.

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Leukotrienes: Inflammatory substances that are released by mast cells during an allergic response or asthma attack.

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Lymphocyte: A specific type of immune cell that can cause tissue damage in the late phase of an allergic reaction.

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Mast cell: An immune system cell which attaches to antibodies and is located in the tissue that lines the nose, bronchial tubes, gastrointestinal tract, and the skin

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Neocromil sodium: An inhaled medication used to treat inflammation involved with asthma.

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Neutrophil: A specific type of immune cell that can cause tissue damage in the late phase of an allergic reaction.

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Otitis media: A middle ear infection. Otitis media with effusion occurs when fluid builds up within the ear.

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Radioallergosorbant Test (RAST): A blood test that measures the amount of IgE antibody produced when the sample is mixed with a specific allergen.

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Rhinitis: An inflammation of the nasal passageways, particularly with discharge.

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Sinusitis: An inflammation or infection of one or more sinuses. The sinuses are hollow air spaces located around the nose and eyes.

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Skin prick test: A test where a needle is used to scratch the skin with a small amount of allergen. A response can usually be seen within 15 - 20 minutes.

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Urticaria: Raised areas of the skin that are often red, warm, and itchy. Urticaria is also known as hives.

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Urushiol: An oil found on poison ivy, oak, and sumac.

Medicines to control osteoarthritis pain must be pain-specific, since osteoarthritis can cause both sudden and chronic pain.

  • If a person experiences unexpected, severe pain from a damaged joint, he or she might benefit from strong pain relievers and muscle relaxants.
  • By contrast, such medications usually are not useful or appropriate for chronic pain, which is more effectively treated by self-management techniques such as proper joint use, joint protection, exercise, medication scheduling, and weight control.

Many medications are used to treat arthritis. Some must be prescribed by a physician, whereas other "over-the-counter" (OTC) products can be bought without a prescription. Consult a physician before taking any new medications, including OTC products. Some OTC products have the same ingredients as prescription medications, so one runs the risk of overdose unless all medications are discussed with a physician.

Over-the-counter pain relievers

Pain relievers like acetaminophen (Tylenol) and aspirin are familiar choices for the treatment of osteoarthritis.

  • Acetaminophen generally is considered safe, although it may pose risks to some individuals with liver disease or when taken in excessive doses.
  • Aspirin is a popular medicine for many arthritic disorders because of its ability to relieve pain as well as inflammation (swelling, redness). However, aspirin is not suitable for people who have had a stomach ulcer or aspirin allergy.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDS relieve pain as well as inflammation. There are a wide variety of NSAIDs to choose from. Over-the-counter forms include:

  • Ibuprofen (Advil, Motrin)
  • Naproxen (Aleve)

Prescription NSAIDs include:

  • Diclofenac (Cataflam, Voltaren)
  • Diflunisal
  • Etodolac
  • Flurbiprofen
  • Ibuprofen (Motrin)
  • Indomethacin (Indocin)
  • Ketoprofen
  • Tolmetin (Tolectin)
  • Meclofenamate
  • Nabumetone (Relafen)
  • Naproxen(Anaprox, Naprosyn)
  • Oxaprozin
  • Piroxicam
  • Salsalate
  • Sulindac (Clinoril)

Unfortunately, NSAIDs have been characterized as having a "double-edged sword," since gastrointestinal (GI) complaints -- which range from stomach upset to ulceration and bleeding -- are common side effects of these medicines.

  • Such complaints sometimes can be controlled by taking the NSAID with food or by using antacids between meals.
  • However, if GI problems are more than mild or are long-lasting, the physician may prescribe an NSAID that causes fewer GI side effects (for example, salsalate).
  • Note that NSAIDs also may cause kidney damage, worsen blood pressure (with salt and fluid retention), and contribute to bleeding by affecting the platelets (clotting elements in the blood).

NSAID partners

The following drugs may be prescribed by a physician to reduce the side effects of NSAIDs:

  • Proton-pump inhibitors -- such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec, Zegerid), pantroprazole (Protonix), and andrabeprazole (Aceiphex) --are used to relieve gastrointestinal symptoms, and have some ability to reduce the risk of NSAID-related ulcers.
  • Antacids help relieve upset stomach and other minor gastrointestinal symptoms (such as nausea, heartburn, indigestion).
  • Misoprostol (Arthrotec) is used to reduce the risk of NSAID-related ulcers.
  • H2-blockers such as ranitidine (Zantac), famotidine (Pepcid), or cimetidine (Tagamet) are used to relieve gastrointestinal symptoms, and may have some ability to reduce the risk of NSAID-related ulcers.

COX-2 inhibitors

These medications reduce the pain of arthritis without causing ulcer disease, and they at least partially prevent the GI complaints associated with NSAIDs. Just one of these medicines, available by prescription only, is still on the market:

  • Celecoxib (Celebrex)

Two other COX-2 inhibitors, valdecoxib (Bextra) and rofecoxib (Vioxx), are no longer available due to increased heart and stroke risks. Celebrex is also not without side effects and risks. Celecoxib may raise blood pressure, and long-term use might increase your risk for heart attack or stroke.

Learn More

Read more about cox-2 inhibitors.

Muscle relaxants

These are sometimes prescribed for osteoarthritis if muscle spasms contribute to a person's discomfort. They include:

  • Cyclobenzaprine (Flexeril)
  • Carisoprodol
  • Methocarbamol (Robaxin)

Other prescription drugs

Sleep medications and antidepressants may be beneficial in certain individuals.

Over-the-counter (OTC) creams, rubs, and sprays

These can be applied topically (to the skin) for temporary relief of pain in a sore muscle or joint. They work in various ways, depending upon their ingredients. Some products contain:

  • Salicylates (aspirin-related compounds that relieve pain)
  • Skin irritants (chemicals that cause cold, warm, or other sensations, thereby reducing feelings of pain)
  • Capsaicin (a "hot" substance found in chili peppers that blocks pain signals to the brain). Most creams, such as those containing capsaicin, must be reapplied three to four times daily and may require 2 -4 weeks of use before effects are noticeable.

Question & Answer

Q: My stomach is easily upset. Will arthritis medicine upset my stomach or give me an ulcer?

A: Make sure that your doctor knows about your stomach problems so that they can prescribe a pain reliever that does not irritate the stomach or cause bleeding from or ulcers in the stomach, which these medications can sometimes do.

Suitable choices may be an aspirin-free pain reliever, such as acetaminophen, or an NSAID that causes fewer GI symptoms. As an alternative, the physician may prescribe an additional medication to lessen the side effects of NSAIDs. It also may be beneficial to switch to the COX-2 inhibitor Celebrex, which can significantly lessen the chance of stomach problems.

Injections into the joint

These are medications a doctor can inject directly into the joint when you go in for an office visit:

 

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Review Date: 11/22/2006

Reviewed By: Alan Greene, M.D., F.A.A.P., Stanford University School of Medicine; Chief Medical Officer, A.D.A.M., Inc.


The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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