Musculoskeletal Conditions Management Guidelines 2018
This document highlights the management guidelines for musculoskeletal conditions such as rheumatoid arthritis and gout, emphasizing the use of medications like prednisone and proton pump inhibitors in certain situations to minimize pain and reduce risks of complications. It also provides resources for detailed evidence informing decision-making on medicine additions, amendments, and deletions.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
E N D
Presentation Transcript
Chapter 14: Musculoskeletal conditions NATIONAL DEPARTMENT OF HEALTH AFFORDABLE MEDICINES ESSENTIAL MEDICINES PROGRAMME PRIMARY HEALTHCARE GUIDELINES 2018 1
EVIDENCE Please access the National Essential Medicines List Committee (NEMLC) report for detailed evidence (including rationale, references and costings) informing decision-making on medicine addition, amendments and deletions: http://www.health.gov.za/index.php/standard-treatment-guidelines-and- essential-medicines-list/category/285-phc DISCLAIMER This slide set is an implementation tool and should be used alongside the most recently published STG available on the EML Clinical Guide Application. This information does not supersede or replace the STG itself. 2
Rheumatoid arthritis DESCRIPTION A chronic inflammatory systemic condition. May affect many organs, but the musculoskeletal system is predominantly affected with several joints becoming painful and swollen. Four S factors are useful to screen for early joint disease. By James Heilman, MD - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?cu rid=11110471 CHANGES Prednisone ADDED for acute symptom control while awaiting rheumatology assessment if NSAIDs contra-indicated. REASON Pragmatic recommendation to minimise pain while awaiting assessment/ definitive management at higher level of care. 3
Rheumatoid arthritis PREVENT By James Heilman, MD - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=11110471 REASON Reduce risk of ulceration in rheumatoid arthritis patients on NSAIDs with a high risk of peptic ulceration. CHANGES Proton pump inhibitors ADDED 4
Gout DESCRIPTION A metabolic disease in which uric acid crystals are deposited in joints and other tissues. Characterised by recurrent attacks of an acute arthritis that often affects one joint which is very painful, tender, swollen, red and hot to the touch. The inflammation may extend beyond the joint. REASON Prednisone recommended if NSAIDS are contraindicated, e.g. peptic ulceration, warfarin therapy and renal dysfunction, or heart failure. CHANGES Prednisone ADDED 5
