You are diagnosed with a chronic synovitis of your right knee. The health practi

Question

You are diagnosed with a chronic synovitis of your right knee. The health practitioner gives you 3 choices for treatment: Naprosyn 250 mg twice daily, Celebrex 200 mg twice daily, or an injection of 4% dexamethasone in the knee joint. Explain the answers to the following:

            a.         What is chronic versus acute inflammation?

            b.         Is there any differences in treating acute versus chronic inflammation?

            c.         How does each of these drugs treat the inflammatory process? Where in the physiological cascade of events does each drug have its effects? What are the potential side effects of each?

Explanation / Answer

a. In Chronic inflamation,the onset is slow which can take days or weeks but in acute inflammation the onset is fast like in minutes or hours. Cellular infiltrate incase of chronicinflammation can be monocytes and lyphocytes while incase of acute inflammation it is mainly neutrophils. The tissuse injury in chronic is mostlysevere while in acute it is mild. The fibrosis in Chronic inflammation is progressive and on contary to this the fibrosis in acute inflmmation is self limited.

b. Acute inflammation is not very severe and hence can be easily treated by taking optimum rest, applying ice on the swollen area. Incase of chronic inflammation , Anti-inflammatory medicines are prescribed and lastly anthroscopicsurgery is employed to treat the inflammation.

c. Naprosyn 250mg twice daily helps to cure inflammtion and relief pain in muscles, joints and bones. The side effects are : Heartburn, Stomach ache, Constipation , Dizziness, Drowsiness, Skin Rash, Fluid retention etc.

Celebrex 200 mg twice daily treats pain and inflammation caused byarithiritis, spondilytis etc. The potential side effect of the drugs include fever, sore throat, rashes on skin,cough sneezing etc.

injection of 4% dexamethasone in the knee joint is used treat chronic knee inflammation and pain. The side effects of this drug are aggression, agitation, anxiety, blurred vision, mood changes, depression, decrease in the maount of urine etc.

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