Treatment of Gout

  Principles of treatment of Gout

- Anti-arthritis in the acute attack.

- Lower blood uric acid to prevent the recurrence of acute arthritis phase, preventing complications.

 

- Treatment of the disease is accompanied by a special group of metabolic diseases such as hypertension, diabetes, increased blood cholesterol, obesity

- For the treatment of arthritis in advance. Only after the status has expired or arthritis remission began taking down uric AICD.

- For effective treatment should regularly check and urinary uric acid levels, kidney function tests.

Treatment of an acute attack

Treatment of gout phase supply is a nonsteroidal anti-inflammatory drugs, colchicine, corticosteroids, including nonsteroidal anti-inflammatory drugs are preferred first choice. Use of drugs depending on the patient and the accompanying pathologies such as kidney disease or peptic.

- Non-steroidal anti-inflammatory drug: It is the drug of first choice for the treatment of gout phase levels in most patients. However, for the elderly and persons with comorbid conditions, need careful consideration when used, should only use this medicine for a short time and at a low dose. The drug should be avoided in patients with kidney disease, stomach ulcers, duodenal or patients taking anticoagulants.

- Colchicine: anti-mitotic drug is extracted from Colchicum autumnal grass roots, a treatment for gout oldest. People have used extracts from herbs to treat gout from 600 BC. Because the drug has a special affinity with polymorphonuclear leukocytes, it reduces the migration of leukocytes, inhibits the phagocytosis of urate crystal salt and thereby stop the formation of lactic acid, keeping the local pH is normal, because the pH factor enabling the monosodium urate crystals precipitated in the tissues in the joints. The drug has no effect on the excretion of uric acid in the urine as well as on the concentration, solubility and protein binding ability of serum uric acid or urate should not alter blood levels of uric acid. However, the drugs have unwanted side effects, led by the upset stomach, intestines, such as diarrhea, vomiting, abdominal pain. Rarely are allergic skin reaction, hair loss, muscle diseases. Prolonged use can lead to bone marrow failure.

- Corticosteroids: In some special cases, for the purpose of treating gout attacks may grant use of oral corticosteroid injection internal short or joints. But because the drugs have side effects and drug abuse because in this country we should not encourage drug use.

Prophylactic treatment of recurrent attacks of gout level

The goal of prophylaxis of gout attacks the blood uric acid level is reduced, limiting the deposition of urate in the tissues and organs thereby limiting recurrent gout attacks and prevent the formation of chronic gout.

- Colchicine: Used for the first time in 1936 for the prevention of recurrent attacks of gout, but is not expected level urate deposition room or the later development of tophi.

- The uric acid-lowering medications: There are many drugs that lower blood uric acid. Depending on the mechanism of action of the drug's impact on the public stage of the metabolism of uric acid in the body that is divided into 3 groups: Group synthesis inhibitors, group and team targets emissions increased uric acid.

Treatment of chronic gout

The goal of treatment is the treatment of chronic gout reduce blood uric acid to prevent complications of chronic renal failure. Commonly used synthetic inhibitors and uric acid can combine the addition of colchicine, depending on the case. It can be used nonsteroidal anti-inflammatory drugs for arthritis patients still evolving.

If you have kidney damage must pay attention to the status of infection (interstitial nephritis), potential kidney failure, high blood pressure, kidney stones, gout ... the prognosis depends on the degree of kidney damage.

some lumps (tophi) to impede the movement can specify surgical resection (tophi in toe shoes are not, in hard wearing elbow, ...).