What is Gout? And what is it's treatment?
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.