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Gout: Causes and Treatment

  1. Gout is a painful rheumatic inflammation of the joints. This inflammation is caused by the formation of uric acid crystals in the joint. The inflammation occurs most frequently in the big toe, which is why the condition is commonly referred to as the paw.

Causes and Treatment of Gout

  1. What should the patient with gout take into account? How Is Gout Treated? Inhibition of uric acid production with uricostatics Stimulation of uric acid excretion with uricosurics Inhibition of leukocyte migration to the joint Administer anti-inflammatory and analgesic medications

What should the patient with gout take into account?

  1. A patient suffering from gout should take the following general advice into account:

How is gout treated?

  1. The aim of treatment is to reduce the symptoms of the acute attack and prevent new attacks. The following strategies are used for this:

Inhibition of uric acid production with uricostatics

  1. The most commonly used uricostatics are allopurinol and febuxostat. The pharmacological effect of allopurinol is due to a metabolite of the compounds, namely alloxanthin. The latter is an inhibitor of the xanthine oxidase, an enzyme that is important for the production of uric acids. Febuxostat also works according to the same pharmacological principle.

Stimulation of uric acid excretion with uricosurics

  1. The most commonly used uricosuric agent is probenecid. Uric acids are freely filtered at the glomerulus in the kidneys, after which they are partially reabsorbed in the proximal tubule. Probenecid will counteract this reabsorption, increasing the excretion of the harmful uric acids.

Inhibition of the migration of leukocytes to the joint

  1. By inhibiting the migration of leukocytes, the inflammatory reaction in the joint is canceled. Colchicine is often used for this. The compound is administered early during an acute attack, resulting in an efficient anti-inflammatory response within 12 to 24 hours.

Administer anti-inflammatory and analgesic medications

  1. NSAIDs, or non-steroidal anti-inflammatory drugs, are the basis for adequate anti-inflammatory treatment. They are used as a first choice for acute gout attacks. Indomethacin, naproxen and diclofenac are the most commonly used NSAIDs for the treatment of gout. In addition to NSAIDs, glucocorticoids are also used in acute gout attacks.



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