First of all, lets us go through with the definition of gout.

Gout is a form of arthritis characterised by redness, severe pain and tenderness due to crystallisation and deposition of uric acids in joints.

There are two types of gout:-

1.Acute Gout:- In this, the aim would be to treat the pain and inflammation, i.e. I will go for symptomatic treatment.

Drugs used in acute gout:-

NSAIDs:-

In this, indomethacin(an NSAID) would be my drug of choice to treat acute gout.

COLCHICINE:-

It blocks the microtubules, and microtubules are required for the movement, i.e. chemotaxis of neutrophils.

It also decreases the chemotactic factor-like IL-1.

They also block phagocytosis because chemotaxis is necessary for chemotactic movement.

The side effect of colchicine:- nausea, Vomiting.

2.CHRONIC GOUT:-

The aim is to decrease uric acid, i.e., to prevent acute gout caused by increased uric acid concentration that deposits in the joints.

So, here I can decrease the uric acid by:-

By decreasing the synthesis of uric acid.

            - For this purpose, a xanthine oxidase inhibitor is used.

            - xanthine oxidase inhibitor will decrease the synthesis of uric acid.

            -ALLOPURINOL -a xanthine oxidase inhibitor is a drug of choice for chronic gout. And conditions associated with other hyperuricemia like tumour lysis syndrome, Lesch-Nyhan syndrome and organ transplant patients. But it may cause acute gout as a side effect because of reflex activity caused by our body due to a sudden decrease in uric acid by allopurinol, so NSAIDs or colchicine is always given with it to prevent this acute gout.

URICOSURIC AGENTS:- They are normally used when there is no response to xanthose oxidase inhibitors. Or in patients with underexcretion of uric acid. Or in patients having tophi. It contains drugs like- 

              SULFINPYRAZONE

             PROBENECID

             LOSARTAN

             FENOFIBRATE.

             LESINURAD.

But these uricosuric drugs cause side effects like urate stone formation, which can cause GIT upset and aplastic anaemia.

 

3.UR CASE ANALOGS:-These is used as a third-line drug. Uricase is the enzyme in birds used for metabolising uric acid into a water-soluble product like allantoin. It contains drugs like-

 1. RASBURICASE

 2. PEGLOTICASE:-But cause hypersensitivity as a side effect.