How is Gout treated- If you are here to know about how is gout treated, then you are in right place. This article will explain the drugs and different methods to treat gout either acute or chronic.
What is Gout?- How is Gout treated
Gout is a metabolic disease, it is an episode of acute arthritis due to the deposits of Uric Acid, the Uric acid will be accumulated in the crystals form in the joints, resulting in hyperuricemia. Gout may be Acute or Chronic.
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Types of Gout
1. Acute Gout: In acute gout, 1-3 joints are only affected, and the symptoms are seen during attacks only, but not after the attack. These attacks may last for few days. There is a chance that this acute gout may lead to chronic.
2. Chronic Gout: The chronic gout attack occurs normally 3-4 times per year. The symptoms of chronic gout also last after the attacks. In this, more than one joint are affected. It may lead to the permanent stiffness of that joint or even damage.
How is Gout treated- If you are here to know about how is gout treated, then you are in right place. This article will explain the drugs and different methods to treat gout either acute or chronic.
What is Gout?- How is Gout treated
Gout is a metabolic disease, it is an episode of acute arthritis due to the deposits of Uric Acid, the Uric acid will be accumulated in the crystals form in the joints, resulting in hyperuricemia. Gout may be Acute or Chronic.
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Types of Gout
1. Acute Gout: In acute gout, 1-3 joints are only affected, and the symptoms are seen during attacks only, but not after the attack. These attacks may last for few days. There is a chance that this acute gout may lead to chronic.
2. Chronic Gout: The chronic gout attack occurs normally 3-4 times per year. The symptoms of chronic gout also last after the attacks. In this, more than one joint are affected. It may lead to the permanent stiffness of that joint or even damage.
How gout is caused?
As early described that it's only due to hyperuricemia, which occurs when the breakdown of nucleic acids is increased, which leads to the accumulation of more purines. Purines are broken down to Hypoxanthine, which is then converted into Xanthine by the action of an enzyme named Xanthine Oxidase on it. Further again Xanthine oxidase act on Xanthine and Uric acid.
How is Gout Treated?-Drugs related to Acute Gout
80% of initial attacks involve a single joint. As the Uric acid is accumulated in the joints, it then releases Prostacyclin (PGI2). That's why NSAIDs are the drugs that are used in the treatment of Acute gout (E.g. Indomethacin).
Glucocorticoids are also used in the treatment of acute gout as they inhibit inflammatory molecules like cytokines, arachidonic acid metabolites, and adhesion molecules (ICAM). These drugs include Prednisolone, Cortisone, etc.
Colchicine is also used in this disorder that binds with intracellular tubulin proteins and prevents the polymerization of microtubules. It disrupts the cytoskeleton of Neutrophils thereby inhibiting migration, phagocytosis, and degranulation that occurs during the inflammatory response.
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The adverse effects of Colchicine include diarrhea, nausea, vomiting, abdominal pain, Aplastic anemia (Agranulocytosis), and Alopecia. It can not be used in pregnancy, and if patients have hepatic, renal, and cardiovascular diseases, they should be used with caution.
How is Gout Treated?-Drugs related to Chronic Gout
As gout occurs due to hyperuricemia, either due to an increase in production or maybe the decrease in excretion of Uric acid. So, here the drugs used will be either the Xanthine oxidase inhibitors (Xanthine oxidase is an enzyme used in the synthesis of uric acid) or the Uricosuric agents (agents that increase the excretion of uric acid).
Xanthine oxidase inhibitors include Allopurinol and Febuxostat, both of these inhibit the production of uric acid by inhibiting the enzyme Xanthine oxidase. As high levels of Uric acid lead to gout attacks or kidney stones.
In some patients, when the therapy of aggressive lymphoma or acute lymphoblastic leukemia is initiated, it causes Tumor lysis syndrome, this is also treated with Allopurinol.
Other drugs group is the Uricosuric agent, which includes Probenecid (a sulfa drug) that decreases the reabsorption of Uric acid, which ultimately leads to the increase in excretion of Uric acid. There is a high risk of renal stone formation due to an increase in the excretion of uric acid. As it also inhibits the excretion of many drugs like penicillin.
If we talk about aspirin, its high doses lead to preventing reabsorption of uric acid, but if low doses are taken, ultimately leads to inhibition of Uric acid excretion.
Another drug named Pegloticase, used in chronic gout management as it is a recombinant uricase, functions by converting Uric acid into Water-soluble Allantoin. This drug may cause hemolysis in the Glucose-6-phosphate deficiency. It may also cause anaphylaxis.
Conclusion-How Gout is treated
Above mentioned drugs are used normally for the treatment of gout, which may be acute or chronic. If a patient has acute, so he or she must take medications to treat it as soon as possible, otherwise acute gout may lead to chronic.
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REFERENCES
1. A literature review of the epidemiology and treatment of acute gout Click here
2. Optimizing current treatment of gout Click here
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