Treatments for Sjogren's Syndrome
Treatments for Sjogren's Syndrome
The list of treatments mentioned in various sources
for Sjogren's Syndrome
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
- Moisture replacement therapies
- Dry eye treatments
- Dry mouth treatments
- Natural saliva stimulation - if you are still producing some saliva
- Chewing gum
- Sucking hard candy
- Frequent sips of water
- Saliva stimulants
- Saliva substitute
- Mouth lubricants
- Lip balms - for dry or cracked lips
- Oral hygiene - helps prevent mouth infectins.
- Brushing teeth
- Rinsing
- Flossing
- Regular dental checkups
- Avoid sugar
- Fluoride supplements
- Dry skin treatments
- Vaginal dryness treatments
- Vaginal moisturizers
- Vaginal lubricant - preferably a water-soluble lubricant rather than oil or petroleum based.
- Skin creams - for outer vaginal areas.
- Treatments for lung problems
- Kidney treatments
- Treatments for digestive, pancreas or liver problems
- Avoid dryness-causing medications
- Avoid antihistamines
- Avoid decongestants
- Avoid diuretics
- Avoid some antidiarrhea drugs
- Avoid some antipsychotic drugs
- Avoid tranquilizers
- Avoid some blood pressure medications
- Avoid antidepressants
- Treatments for immune or inflammation causes of Sjogren's and related disorders
- Specialized planning and treatment of pregnancy for women with Sjogren's
- Wetting drops called artificial tears
- Autologous serum eye drops
- Fish consumption and omega-3 fatty acids
- Lubricating ointments (in more severe cases)
- Tiny plugs placed in the tear drainage ducts to help the tears stay on the surface of the eye
- Medications such as Restasis, topical corticosteroids, and oral tetracycline and doxyccycline
- Surgery may be used if the eyelids are in an abnormal position
- Customized contact lenses
Sjogren's Syndrome: Is the Diagnosis Correct?
The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for Sjogren's Syndrome may include:
Hidden causes of Sjogren's Syndrome may be incorrectly diagnosed:
Sjogren's Syndrome: Marketplace Products, Discounts & Offers
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Drugs and Medications used to treat Sjogren's Syndrome:
Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment
or change in treatment plans.
Some of the different medications used in the treatment of Sjogren's Syndrome include:
- Pilocarpine
- Adsorbocarpine
- Akarpine
- Almocarpine
- E-Pilo Preparations
- I-Pilopine
- Isopto Carpine
- Minims
- Miocarpine
- Ocusert Pilo-20
- Ocusert Pilo 40
- PE Preparations
- Pilagan
- Pilocar
- Pilopine HS
- Piloptic-1
- Piloptic-2
- Pilosyst 20/40
- Salagen
- Spersacarpine
- Cortate
- Cortisone Acetate
Unlabeled Drugs and Medications to treat Sjogren's Syndrome:
Unlabelled alternative drug treatments for Sjogren's Syndrome include:
- Chlorambucil - used in combination with corticosteroids
- Leukeran - used in combination with corticosteroids
- Alti-Chlorambucil - used in combination with corticosteroids
- Hydroxychloroquine
- Plaquenil
Medical news summaries about treatments for Sjogren's Syndrome:
The following medical news items
are relevant to treatment of Sjogren's Syndrome:
Discussion of treatments for Sjogren's Syndrome:
NINDS Sjogren's Syndrome Information Page: NINDS (Excerpt)
There is no known cure for Sjogren's syndrome nor is
there a specific treatment to restore gland secretion. Treatment is
generally symptomatic and supportive. Moisture replacement therapies may
ease the symptoms of dryness. Nonsteroidal anti-inflammatory drugs may be
used to treat musculoskeletal symptoms. For individuals with severe
complications, corticosteroids or immunosuppressive drugs may be
prescribed.
(Source: excerpt from NINDS Sjogren's Syndrome Information Page: NINDS)
Questions and Answers About Sjögren's Syndrome: NIAMS (Excerpt)
Treatment is different for each person, depending on what
parts of the body are affected. But in all cases, the doctor will help
relieve your symptoms, especially dryness. For example, you can use
artificial tears to help with dry eyes and saliva stimulants and mouth
lubricants for dry mouth. Treatment for dryness is described in more
detail below.
If you have extraglandular involvement, your doctor--or
the appropriate specialist--will also treat those problems. Treatment
may include nonsteroidal anti-inflammatory drugs for joint or muscle
pain, saliva- and mucus-stimulating drugs for nose and throat dryness,
and corticosteroids or drugs that suppress the immune system for lung,
kidney, blood vessel, or nervous system problems. Hydroxychloroquine,
methotrexate, and cyclophosphamide are examples of such
immunosuppressants (drugs that suppress the immune system).
What Can I Do About Dry
Eyes?
Artificial tears can help. They come in different
thicknesses, so you may have to experiment to find the right one. Some
drops contain preservatives that might irritate your eyes. Drops without
preservatives don't usually bother the eyes. Nonpreserved tears
typically come in single-dose packages to prevent contamination with
bacteria.
At night, an eye ointment might provide more relief.
Ointments are thicker than artificial tears and moisturize and protect
the eye for several hours. They may blur your vision, which is why some
people prefer to use them while they sleep.
Hydroxypropyl methylcellulose (Lacriserts*) is a chemical
that lubricates the surface of the eye and slows the evaporation of
natural tears. It comes in a small pellet that you put in your lower
eyelid. When you add artificial tears, the pellet dissolves and forms a
film over your own tears that traps the moisture.
Another alternative is surgery to close the tear ducts
that drain tears from the eye. The surgery is called punctal occlusion.
For a temporary closure, the doctor inserts collagen or silicone plugs
into the ducts. Collagen plugs eventually dissolve, and silicone plugs
are "permanent" until they are removed or fall out. For a longer lasting
effect, the doctor can use a laser or cautery to seal the ducts.
* Brand names included in this booklet are
provided as examples only, and their inclusion does not mean that these
products are endorsed by the National Institutes of Health or any other
Government agency. Also, if a particular brand name is not mentioned,
this does not mean or imply that the product is
unsatisfactory.
|
General Tips for Eye Care
-
Don't use artificial tears that irritate your
eyes--try another brand or preparation.
-
Nonpreserved drops may be more
comfortable.
-
Blink several times a minute while reading or
working on the computer.
-
Protect your eyes from drafts, breezes, and
wind.
-
Put a humidifier in the rooms where you spend the
most time, including the bedroom, or install a humidifier in
your heating and air conditioning unit.
-
Don't smoke and stay out of smoky
rooms.
-
Apply mascara only to the tips of your lashes so
it doesn't get in your eyes. If you use eyeliner or eye shadow,
put it only on the skin above your lashes, not on the sensitive
skin under your lashes, close to your eyes.
-
Ask your doctor whether any of your medications
contribute to dryness and, if so, how to reduce that effect.
|
What Can I Do About Dry
Mouth?
If your salivary glands still produce some saliva, you can
stimulate them to make more by chewing gum or sucking on hard candy.
However, gum and candy must be sugar free because dry mouth makes you
extremely prone to cavities. Take sips of water or another sugar free
drink often throughout the day to wet your mouth, especially when you
are eating or talking. Note that you should take sips of water--drinking
large amounts of liquid throughout the day will not make your mouth any
less dry. It will only make you urinate more often and may strip your
mouth of mucus, causing even more dryness. You can soothe dry, cracked
lips by using oil- or petroleum-based lip balm or lipstick. If your
mouth hurts, the doctor may give you medicine in a mouth rinse,
ointment, or gel to apply to the sore areas to control pain and
inflammation.
If you produce very little saliva or none at all, your
doctor might recommend a saliva substitute. These products mimic some of
the properties of saliva, which means they make the mouth feel wet, and
if they contain fluoride, they can help prevent cavities. Gel-based
saliva substitutes tend to give the longest relief, but all saliva
products are limited since you eventually swallow them.
At least two drugs that stimulate the salivary glands to
produce saliva are available. These are pilocarpine and cevimeline. The
effects last for a few hours, and you can take them three or four times
a day. However, they are not suitable for everyone, so talk to your
doctor about whether they might help you.
People with dry mouth can easily get mouth infections.
Candidiasis, a fungal mouth infection, is one of the most commonly seen
in people with Sjögren's. It most often shows up as white patches inside
the mouth that you can scrape off, or as red, burning areas in the
mouth. Candidiasis is treated with antifungal drugs. Various viruses and
bacteria can also cause infections; they're treated with the appropriate
antiviral or antibiotic medicines.
|
The Importance of Oral Hygiene
Natural saliva contains substances that rid the
mouth of the bacteria that cause cavities and mouth infections, so
good oral hygiene is extremely important when you have dry mouth.
Here's what you can do to prevent cavities and infections:
-
Visit a dentist at least three times a year to
have your teeth examined and cleaned.
-
Rinse your mouth with water several times a day.
Don't use mouthwash that contains alcohol because alcohol is
drying.
-
Use fluoride toothpaste to gently brush your
teeth, gums, and tongue after each meal and before bedtime.
Nonfoaming toothpaste is less drying.
-
Floss your teeth every day.
-
Avoid sugar. That means choosing sugar-free gum,
candy, and soda. If you do eat or drink sugary foods, brush your
teeth immediately afterward.
-
Look at your mouth every day to check for redness
or sores. See a dentist right away if you notice anything
unusual or have any mouth pain or bleeding.
-
Ask your dentist whether you need to take fluoride
supplements, use a fluoride gel at night, or have a protective
varnish put on your teeth to protect the enamel.
|
(Source: excerpt from
Questions and Answers About Sjögren's Syndrome: NIAMS)
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for more information about the treatments of Sjogren's Syndrome.
Red Eye:
Treatment
(In a Page: Signs and Symptoms)
-
Ophthalmologic referral for HSV/herpes zoster keratitis or conjunctivitis, acute angle-closure glaucoma, scleritis, corneal ulcer, iritis, penetrating foreign bodies
-
Avoid treating patients with steroid eyedrops without ophthalmologic consultation
- Conjunctivitis
–Allergic: Avoid offending agents, cold compresses to eyes, NSAIDs, ocular decongestants, antihistamines
–Viral: Self-limited, good hygiene to avoid spread
–Bacterial: Antibiotic eye drops; avoid neomycin,
because allergic reactions are common
-
Subconjunctival hemorrhage: Reassurance, cool compresses, clears spontaneously in 1–2 weeks
-
Chemical eye injury: Immediate copious irrigation with normal saline for at least 30 minutes
-
Preventative measures include proper hygiene and daily cleaning of contact lenses, proper hand-washing techniques before all contact with eyes, eye protection in occupations entailing possible ocular injury
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Scleral Injection (Red Eye):
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Intense topical antibiotics for corneal ulcers
-
Topical antibiotics for bacterial conjunctivitis (sulfa, fluoroquinolones; avoid gentamicin)
-
Consider systemic ceftriaxone if suspect Gonococcus
-
Tears, cool compresses, topical and oral antihistamines for allergic conjunctivitis
-
Frequent handwashing for viral conjunctivitis
-
Oral doxycycline and treatment of partners for chlamydia
-
NSAIDs for epi/scleritis
-
Oral doxycycline, topical Metrogel, warm compresses for rosacea, chalazia, and blepharitis
-
Massage of inner canthus, hot compresses, oral and topical antibiotics for canaliculitis and dacrocystitis
-
Check intraocular pressure if suspect angle closure glaucoma (pressure typically over 40 mmHg)
-
Frequent lubrication for dry eye
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Conjunctivitis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment for conjunctivitis varies with the cause. Bacterial conjunctivitis requires topical application of the appropriate broad-spectrum antibiotic. Although viral conjunctivitis resists treatment, a sulfonamide or broad-spectrum antibiotic eyedrops may prevent a secondary infection. Patients may be contagious for several weeks after onset. The most important aspect of treatment is preventing transmission. Herpes simplex infection generally responds to treatment with trifluridine drops or vidarabine ointment or oral acyclovir, but the infection may persist for 2 to 3 weeks. Treatment for vernal (allergic) conjunctivitis includes administration of corticosteroid drops followed by cromolyn sodium, cold compresses to relieve itching and, occasionally, oral antihistamines.
Instillation of a one-time dose of erythromycin or 1% silver nitrate solution (Credé’s procedure) into the eyes of neonates prevents gonococcal conjunctivitis.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Inclusion conjunctivitis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Because infection isn’t limited to the eye in neonates, infants, or adults, systemic antimicrobial treatment is necessary. In infants, effective therapy is achieved with erythromycin. Adults may be given tetracycline, doxycycline, or erythromycin.
Prophylactic tetracycline or erythromycin ointment is applied once, 1 hour after delivery. However, this treatment hasn’t been found to be significantly more effective than Credé’s method (1% silver nitrate).
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Sjögren's syndrome:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment is usually symptomatic and includes conservative measures to relieve ocular or oral dryness. Mouth dryness can be relieved by using a methylcellulose swab or spray and by drinking plenty of fluids, especially at mealtime. Meticulous oral hygiene is essential, including regular flossing, brushing, at-home fluoride treatment, and frequent dental checkups.
Instill artificial tears as often as every half hour to prevent eye damage (corneal ulcerations and corneal opacifications) from insufficient tear secretions. Some patients may also benefit from instillation of an eye ointment at bedtime or from twice-a-day use of sustained-release cellulose capsules (Lacrisert). If infection develops, antibiotics should be given immediately; topical steroids should be avoided. Other treatment measures vary with associated extraglandular findings. Parotid gland enlargement requires local heat and analgesics. Pulmonary and renal interstitial disease necessitate corticosteroid use. Accompanying lymphoma is treated with a combination of chemotherapy, surgery, or radiation.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Keratitis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment for acute keratitis due to herpes simplex virus consists of trifluridine eyedrops, vidarabine ointment, or oral acyclovir. A broad-spectrum antibiotic may prevent secondary bacterial infection. Dendritic keratitis may become chronic with recurrent episodes. Bacterial corneal ulcers require intense topical eyedrop instillation every half hour for the first 48 hours with 2 broad-spectrum antibiotics. Long-term topical therapy may be necessary. (Corticosteroid therapy is contraindicated in dendritic keratitis or any other viral or fungal disease of the cornea.) Fungal keratitis is treated with natamycin.
Exposure keratitis is treated with ointment at night and frequent instillation of artificial tears during the day. A plastic bubble shield may prevent tear evaporation. Vision may be restored by penetrating keratoplasty (corneal transplant) in blindness resulting from corneal scarring.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Conjunctival injection:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient with conjunctival injection reports a chemical splash to the eye, quickly irrigate the eye with copious amounts of normal saline solution. (First, remove contact lenses.) Evert the lids and wipe the fornices with a cotton-tipped applicator to remove any foreign body particles and as much of the chemical as possible.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Conjunctivitis:
Treatment
(Handbook of Diseases)
The cause of conjunctivitis dictates the treatment. Bacterial conjunctivitis requires topical application of the appropriate antibiotic or sulfonamide. If the causative agent is N. gonorrhoeae, a single I.M. dose of ceftriaxone is usually given. If the cornea is involved, a 5-day I.M. course is required.
Although viral conjunctivitis resists treatment, broad-spectrum antibiotic eyedrops may prevent secondary infection.
Herpes simplex infection generally responds to treatment with trifluridine drops, vidarabine ointment, or oral acyclovir, but the infection may persist for 2 to 3 weeks. Treatment of vernal (allergic) conjunctivitis includes administration of corticosteroid drops followed by lodoxamide tromethamine, a histamine1 antagonist, cold compresses to relieve itching and, occasionally, an oral antihistamine.
Instillation of a one-time dose of erythromycin into the eyes of newborns prevents gonococcal and chlamydial conjunctivitis.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Inclusion conjunctivitis:
Treatment
(Handbook of Diseases)
Treatment consists of 1% tetracycline eyedrops, erythromycin ophthalmic ointment, or sulfonamide eyedrops five or six times daily for 2 weeks for infants and oral tetracycline or erythromycin for 3 weeks for adults. Adults with severe disease may also require systemic therapy. Sexual partners should also be examined and treated.
Prophylactic tetracycline or erythromycin ointment is applied once, 1 hour after delivery.
Clinical tip The Credé prophylaxis doesn’t protect against inclusion conjunctivitis.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Sjögren's syndrome:
Treatment
(Handbook of Diseases)
Usually symptomatic, treatment includes conservative measures to relieve ocular or oral dryness.
Symptomatic treatment
Mouth dryness can be relieved by using a methylcellulose swab or spray and by drinking plenty of fluids, especially at meals. New agents for treatment of salivary hypofunction, such as pilocarpine hydrochloride or bromhexine, may be useful. Meticulous oral hygiene is essential, including regular flossing, brushing, and fluoride treatment at home and frequent dental checkups.
Instillation of artificial tears as often as every half hour prevents eye damage (corneal ulcerations, corneal opacifications) from insufficient tear secretion.
CLINICAL TIP: Artificial tears, whose drops are thicker and more viscous, require less frequent application but may cause blurring or leave residue on eyelashes.
Some patients may also benefit from instillation of an eye ointment at bedtime, or from twice-a-day sustained-release cellulose capsules.
If an eye infection develops, antibiotics should be given immediately; topical steroids should be avoided.
Other measures
Other treatment measures vary with associated extraglandular findings. Parotid gland enlargement requires local heat and analgesics; arthritis and arthralgias, hydroxychloroquine or nonsteroidal anti-inflammatory drugs; pulmonary and renal interstitial disease, corticosteroids; accompanying lymphoma, a combination of chemo-therapy, surgery, and radiation.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Keratitis:
Treatment
(Handbook of Diseases)
With acute keratitis due to herpes simplex virus, treatment consists of trifluridine eyedrops or vidarabine ointment. A broad-spectrum antibiotic may prevent secondary bacterial infection.
Chronic dendritic keratitis may respond more quickly to vidarabine. Long-term topical therapy may be necessary. (Corticosteroid therapy is contraindicated in patients with dendritic keratitis or another viral or fungal disease of the cornea.) Treatment of fungal keratitis involves natamycin.
Keratitis due to exposure requires application of moisturizing ointment to the exposed cornea and of a plastic bubble eye shield or eye patch. Treatment of severe corneal scarring may include keratoplasty (cornea transplantation).
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Conjunctival injection:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If the patient with conjunctival injection reports a chemical splash to the eye, first remove the contact lenses, and then quickly irrigate the eye with copious amounts of normal saline solution. Evert the lids and wipe the fornices with a cotton-tipped applicator to remove any foreign body particles and as much of the chemical as possible.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Conjunctival injection:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for such diagnostic tests as orbital X-rays, ocular ultrasonography, and fluorescein staining.
▪ Obtain cultures of any eye discharge, and record its appearance, consistency, and amount.
▪ If the patient complains of photophobia, darken the room or recommend that he wear sunglasses.
Patient teaching
▪ If the patient's visual acuity is markedly decreased, orient him to his environment to ensure his comfort and safety.
▪ Because most forms of conjunctivitis are contagious, stress the importance of frequent hand washing and of not touching the affected eye.
▪ Teach the patient ways to reduce photophobia.
▪ Explain the cause of conjunctival injection and its treatment.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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