Which of the following is the first-line treatment for juvenile rheumatoid arthritis?
a. corticosteroids
b. nonsteroidal anti-inflammatory drugs (NSAIDs)
c. slow-acting antirheumatic drugs (SAARDs)
d. hydrochloroquine
B
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A Incorrect. For years corticosteroids were commonly used to slow the inflammatory process to relieve pain, maintain function, and promote normal growth and development. However, there are many adverse side effects with these drugs, and they are not the first-line treatment.
B Correct. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-line treatment for JRA. Not only do they decrease inflammation by decreasing production of the inflammatory substance prostaglandin, but they are also antipyretic, helping decrease fever.
C Incorrect. Slow-acting antirheumatic drugs (SAARDs), such as sulfasalazine, may be used in combination with NSAIDs to control inflammation, but are not the first-line treatment.
D Incorrect. Hydrochloroquine, an anti-malarial drug, has been used to treat JRA but is not the first-line treatment.
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