Children’s Medicine: How Custom Compounding for Juvenile Arthritis Can Help
Every day we see patients who come in to fill their regular prescriptions for arthritis drugs. Many of our patients are elderly or active adults who have developed their conditions through work or exercise. Once in a while, however, we’ll get a parent who comes in with a prescription from children’s medicine, maybe for a daughter who gets fevers all the time, who has joint pain that wracks her body, and swelling in her knees and feet that comes on suddenly and isn’t easy to get rid of. Kids like these suffer from juvenile arthritis (JA), and it’s heartbreaking to see them struggle with pain no child should have to endure.1
JA isn’t a simple disease—or even a disease at all—but is an umbrella term that covers a range of autoimmune and inflammatory conditions that affect young children up to and including their teenage years. There are a number of different types of JA that attack different parts of the body, but the commonality is pain and joint swelling. Although there is no cure for JA, knowing what type your patient suffers from can help pharmacists, the patient, and her children’s medicine physician develop the right treatment plan.
Juvenile idiopathic arthritis is the most common type of arthritis we see in children’s medicine, and occurs because the child’s immune system attacks her own tissues, particularly in the joints. There are other types of JA, as well, however, including:
- Juvenile dermatomyositis, which causes muscle weakness and a rash on the eyelids and knuckle;
- Juvenile lupus, which can affect every organ in the body;
- Juvenile scleroderma, which causes the skin to tighten and harden;
- Kawasaki disease, which causes inflammation in the blood vessels and leads to other heart complications;
- Mixed connective tissue disease, which presents as a combination of the types described above; and
- Fibromyalgia, which primarily affects disease and causes stiffness, aching, extreme fatigue, and insomnia.
With as many symptoms and areas of the body JA presents in, children’s medicine does not have a simple cure or treatment regimen to offer.
Custom Compounding Is an Important Part of Children’s Medicine
Juvenile Arthritis is a difficult disease for children to deal with not just because of the pain, which is significant, but also because of the physical and social gap it forces on kids. Most people aren’t aware that JA is not a permanent life sentence. In many cases, the disease resolves before the patient matures to adult age, but even if it does not, early intervention is key. The longer a patient waits to reduce swelling and mitigate loss in joint movement, the more likely he is to have permanent pain and even to suffer from other connected conditions, such as stunted or uneven growth, or inflammation of the eye that can lead to blindness.
Treatment usually involves a blend of medications and physical activities designed to manage pain, swelling and joint movement while still giving the patient a good quality of life2, something that’s especially important for kids. The regimen can be tough but the benefits include allowing kids enjoy the type of life they need to live at such a young age.
Because the symptoms of JA come and go and affect different joints to different degrees, developing a treatment regimen unique to each patient is key. This is where custom compounding can come in. Over-the-counter drugs are usually where most patients start, but long-term treatment requires physician exams and recommendations. Some common medicines include:
- Disease-modifying anti-rheumatic drugs, which slow down immune system but cause stomach and liver problems;
- Biologic response modifiers, which focus on changing processes within the body, such as blocking inflammation proteins, but which come with side effects such as internal infection;
- Corticosteroids, which are strong anti-inflammatories, but again can also cause long-term infection, as well as decrease in bone integrity;
- Topical NSAIDS in cream for immediate relief; and
- Vitamins and natural supplements that act as anti-inflammatories with fewer side effects and other natural remedies.3
Stocking the pharmacy dispensary with a quality treatment options is key in order to offer the right balance of medicines for the types of JA each patient suffers from. Additionally, any treatment plan must be developed with knowledge of potential allergies that might set off even more issues in an immunocompromised child. Physical therapy and other physical activities should also be a part of the treatment regimen and can help a child stay active and healthy, which is essential for her social life. As symptoms change and new compounding treatments become necessary, pharmacists should focus on communication with their young patients and their parents to get the necessary information to design a new treatment. It can be hard to get a child to open up about a disease he or she just wants to go away, but pharmacists are suited to taking the time and consideration to help each child get the treatment he or she deserves.
There is no cure for JA, but with children’s medicine’s focus on management of disease symptoms, these kids can live a normal, healthy life. It’s important that pharmacists know how to listen and read between the lines, but also that we have the right treatments on hand to give these children the relief they so badly need.
It’s hard to see kids in pain and to see it affect their lives. Children’s medicine is one aspect of compounding that Pharmaceutica North America is dedicated to. We a proven record of providing safe and high-quality custom compounding materials for even our youngest patients. Please contact us today to learn more about how we can help you deliver effective personalized medicines that will make an impact not just on your patient’s medical conditions, but on their emotional and social health, too.
- “Juvenile Arthritis: Early Signs and Symptoms,” 2015, http://www.kidsgetarthritistoo.org/about-ja/juvenile-arthritis-early-signs-and-symptoms.php ↩
- “What Is Juvenile Arthritis? Fast Facts<” November 2014, http://www.niams.nih.gov/Health_Info/Juv_Arthritis/juvenile_arthritis_ff.asp#6 ↩
- “Unconventional Remedies Used for Patients With Juvenile Arthritis,” March 24, 1989, “http://pediatrics.aappublications.org/content/85/2/150.short ↩