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Given the symptoms, the diagnosis of the woman has been determined to be osteoarthritis (OA) in its initial stages. OA results from a breakdown of joint cartilage due to excessive stress on joints, previous injury, or an underlying disorder of the cartilage. The breakdown of the Cartilage is associated with pain and even rigidity of the joints.
Since osteoarthritis has no cure; only treatments for the management of symptoms are available. When prescribing medication for osteoarthritis, the recommended first-line therapy is acetaminophen, which falls under the class of Analgesics pain relievers. Nonsteroidal anti-inflammatory drugs (NSAIDS) such as celecoxib and ibuprofen are recommended as the second line. They are useful in the easing of inflammation and any associated pain. As a third line measure, intra-articular corticosteroids which are powerful anti-inflammatory medications are recommended to be either taken by mouth or injected into a joint (Nelson, Allen, Golightly, Goode, & Jordan, 2014).
The most appropriate medication, in this case, is NSAIDs such as ibuprofen which will ease the small amount of swelling as well as reduce the pain (McAlindon et al., 2014). The woman should also manage her weight given that her BMI is at 26.5, hence overweight. She is also reported to be taking trazodone HCl, an antidepressant, for its sleepiness side effects and pain relieving properties. Trazodone interacts with NSAIDs, and this can increase the risk of bleeding (Varney, Womersley, & Agius, 2017). For this reason, the use of trazodone should be discontinued immediately. The NSAIDs administered are sufficient to treat the TMJ symptoms (Wang, Zhang, Gan, & Zhou, 2015).
McAlindon, T. E., Bannuru, R., Sullivan, M. C., Arden, N. K., Berenbaum, F., Bierma-Zeinstra, S. M., … & Kwoh, K. (2014). OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis and cartilage, 22(3), 363-388.
Nelson, A. E., Allen, K. D., Golightly, Y. M., Goode, A. P., & Jordan, J. M. (2014, June). A systematic review of recommendations and guidelines for the management of osteoarthritis: the chronic osteoarthritis management initiative of the US bone and joint initiative. In Seminars in arthritis and rheumatism (Vol. 43, No. 6, pp. 701-712). Elsevier.
Varney, A., Womersley, K., & Agius, M. (2017). What are the risks associated with the use of NSAIDs as an adjunct to SSRIs for treatment of depression? An evaluation of current evidence. Psychiatria Danubina, 29(Suppl 3), 375-382.
Wang, X. D., Zhang, J. N., Gan, Y. H., & Zhou, Y. H. (2015). Current understanding of pathogenesis and treatment of TMJ osteoarthritis. Journal of dental research, 94(5), 666-673.
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