Giant Cell Arteritis (GCA) is an inflammatory condition affecting the large and medium-sized arteries, that reside in the head and neck. It typically presents in patients that are over 50 years old with a higher incidence in women and those individuals of Northern European descent. This disease state presents with a range of symptoms that include severe headaches, scalp tenderness, pain while chewing and visual disturbances (e.g. double vision or sudden vision loss). The patient will often report systemic symptoms such as fever, fatigue, weight loss and muscle pain, particularly in the shoulders and hips. These symptoms can be abrupt or develop gradually over time.

The primary concern with GCA is the risk of vision loss due to inflammation of the arteries supplying the eye. Importantly, if left untreated GCA can lead to permanent blindness. Other serious complications include aortic aneurysms and strokes. As such, early diagnosis is key!

The mainstay of drug treatment for GCA is high-dose corticosteroids (e.g. Prednisolone), which are started immediately upon suspicion of the diagnosis to prevent vision loss. Due to the long-term nature of steroid use, cessation involves the gradual tapering of the dose over time. Chronic steroid use is often requiring long-term therapy to prevent relapse. To guard against corticosteroid side effects, drugs such as bisphosphonates and proton pump inhibitors are used to protect against bone loss and gastrointestinal side effects, respectively.

Here, at www.pharmascholar.co.uk we believe it is important to release this blog entry because an awareness of GCA is vital for developing university student understanding around the elements of diagnostics and clinical management skills. A clear understanding of the presentation and complications of GCA helps students recognise the urgency of early intervention. Indeed, case-based scenarios may be discussed with our Lead Tutor, Dr Davies, whereby students analyse patient scenarios involving GCA to enhance their clinical reasoning and decision-making skills. Further, discussion around the interpretation of diagnostic tests like ESR and CRP levels can provide improvement of student comprehension of this field. The e-BNF can subsequently be applied to guide prescribing decisions and also prepare individuals for the Prescribing Safety Assessment (PSA), for example.

It is important for Pharmacy and Medical Students, for instance, to develop a good understanding of GCA so that the condition can be managed effectively during future clinical practice. Appropriate care of the patient (i.e. drug use and related tapering) will ultimately improve clinical outcomes related to this condition. Please book your appointment today with Dr Davies to find out more….