Medically Reviewed by: William C. Shiel, Jr, MD, FACP, FACR

Analgesics: A drug that relieves pain. There are many types of pain medications. Some pain medications are actually combinations of drugs that work together to relieve pain. Some pain medications are available over-the-counter (without a prescription), such as aspirin, acetaminophen, ibuprofen, and naproxen, or with a prescription, such as the narcotics oxycodone, propoxyphene, and codeine. Narcotic pain relievers can be habit-forming.

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Biological Response Modifiers (BRMs)--also known as Biologic DMARDS (Disease-Modifying Antirheumatic Drugs):: Substances that modify the body's response to infection and disease. The body naturally produces small amounts of these substances. Scientists can produce some of them in the laboratory in large amounts for use in treating cancer, rheumatoid arthritis, and other diseases.
BRMs used in biological therapy include monoclonal antibodies, interferon, interleukin-2 (IL-2), and several types of colony- stimulating factors (CSF, GM-CSF, G-CSF). Interleukin-2 and interferon are BRMs being tested for the treatment of advanced malignant melanoma. Interferon is a BRM now in use to treat hepatitis C.

The side effects of BRM therapy often include flu-like symptoms such as chills, fever, muscle aches, weakness, loss of appetite, nausea, vomiting, and diarrhea. Some patients develop a rash, and some bleed or bruise easily. Interleukin therapy can cause swelling. Depending on the severity of these problems, patients may need to stay in the hospital during treatment. These side effects are usually short-term and go gradually away after treatment stops.

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Disease-Modifying Antirheumatic Drugs or DMARDs: While "first-line" medications (NSAIDs and corticosteroids) can relieve joint inflammation and pain, they do not necessarily prevent joint destruction or deformity. For patients with an aggressively destructive form of rheumatoid arthritis, medications other than NSAIDs and corticosteroids are needed. These "second-line" or "slow-acting" medicines (listed below) may take weeks to months to become effective. They are used for long periods of time, even years, at varying doses. If effective, they can promote remission, thereby retarding the progression of joint destruction and deformity. Sometimes a number of second-line medications are used together as combination therapy.

Hydroxychloroquine (PLAQUENIL) is related to quinine, and is used in the treatment of malaria. It is used over long periods for the treatment of rheumatoid arthritis. Side effects include upset stomach, skin rashes, muscle weakness, and vision changes. Even though vision changes are rare, patients taking PLAQUENIL should be monitored by an eye doctor (opthalmologist).