Treatment of joints

Medications for gout: what to choose the set of available funds?

Medication therapy plays a leading role in the treatment of gout. And physiotherapy, sanatorium-and-spa treatment, traditional medicine play only a supporting role. And the selection of medicines should be carried out by a rheumatologist, taking into account the phase of the disease and possible contraindications. And, before deciding what should be the cure for gout, it is worthwhile to briefly dwell on the pathogenesis and the clinic of this disease.

General principles of drug treatment

The development of gout is based on the accumulation in the body of uric acid compounds - urates. Clinically significant manifestations of this disease are specific inflammatory processes in the joints - gouty arthritis. A few years after the development of arthritis, tofu are formed - accumulations of urates in the form of subcutaneous nodules with localization in the region of the ear concha, joints, shins, forearms. With neglected forms of gout, it is possible to damage internal organs and develop chronic renal failure.

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Comprehensive treatment of gout with medicines has the following objectives:

  • Correction of uric acid exchange
  • Elimination of gouty arthritis
  • Treatment of tofusi
  • Prevention of renal failure

In this connection, drugs of various groups are used: tablets, injectable vials, ointments for external use.

Correction of metabolic processes

The effect on the metabolism of uric acid in gout involves the cessation of its entry into the body, the inhibition of its synthesis, and the enhancement of its excretion in the urine. Termination of urate intake is achieved through an appropriate diet, and medicines are not used here. Drugs from the group of uricodepressants interrupt the sequence of certain biochemical reactions, as a result of which the formation of uric acid is inhibited. To this end, use tablets from gout - Allopurinol, Thiopurinol, Allomaron. The latter has a complex effect - reduces synthesis and enhances the excretion of urates.

Urikozuricheskie means contribute to the allocation of urate in the urine. Conventional diuretics in this case are not only ineffective, but also contraindicated. Urodan, Urolesan, Benzobromarone, and Ketazon have a uricosuric effect. It should be noted that the accumulation of urate may complicate some other diseases - coronary heart disease, diabetes, thyrotoxicosis, certain bacterial and viral infections. Effective treatment of these diseases will inevitably lead to a decrease in the level of uric acid. It should be noted that the use of uricodepressive and uricosuric agents does not always facilitate the course of gouty arthritis. For example, Allopurinol is ineffective for treating gout exacerbation.

Treatment of arthritis

Aggravation occurs in the form of gouty arthritis with typical symptoms - edema, pain, stiffness of movements. The best remedy for gout gout in such cases is Colchicine. This drug affects the deposition of crystals of uric acid in the joints and inhibits the release of biologically active substances responsible for the course of inflammatory reactions. Ultimately, pain and movement limits are eliminated in gouty arthritis.

We also recommend reading:

Methods of treating gout on the legs

Similar action is taken by other medicines for gout - non-steroidal anti-inflammatory drugs( NSAIDs).These drugs have a direct anti-inflammatory effect, and some of them, for example, Butadione and its derivatives, also have a uricosuric effect. However, not all NSAIDs are indicated for gout. Derivatives of Acetylsalicylic acid have the opposite effect - they prevent the excretion of urates, and therefore are contraindicated in this disease.

In general, NSAIDs for the treatment of gout are desirable to use combined, in various dosage forms. Simultaneously, pills and ointment from gout containing Diclofenac, Indomethacin, Ibuprofen are used. Naproxen and other NSAIDs. Using these medicines, one should not forget about their negative effect on the function of the liver, stomach and intestines. But these organs and so provoked with gout. Other anti-inflammatory drugs, steroid hormones( Hydrocortisone, Diprospan, Kenalog) are injected directly into the joint cavity. But these drugs are used only in extreme cases, when a pronounced inflammatory process led to the accumulation of a large amount of intra-articular fluid.

Treatment of late complications

Tofuses are formed several years after the first exacerbation of gout. In most cases, they are painless. Although in some cases, increasing tofusis, localized in the projection of the joints, can complicate the course of gouty arthritis. Nevertheless, it is not necessary to open them by themselves. With timely complex antipodal treatment, they themselves decrease. Sometimes these specific granulomas can be opened independently. Opened tofusi treated with antiseptics. Dimexide, iodine-containing products, any ointments containing antibiotics are suitable for this.

Chronic renal failure( CRF) is an extremely undesirable complication of gout. To avoid chronic renal failure, abundant drinking and periodic infusions( intravenous infusions) of alkaline solutions are recommended. The alkalization prevents the deposition of urate stones in the renal pelvis. To this end, resort to infusions of sodium bicarbonate( soda), various electrolyte solutions. These solutions, as well as other drugs, should be used under careful laboratory control. In the course of laboratory studies of blood and urine, the acid-base state, the amount of urates excreted, is estimated. Therefore, all patients in the phase of gout exacerbation should be observed by a rheumatologist in a hospital.

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Drugs for gout: which medications help cure gouty arthritis

Gout is a disease in which deposits of uric acid salts are deposited in various tissues, including in the joints of the legs( usually the big toes), whose crystals causepain and inflammation in the joint. Gouty arthritis is a metabolic disease, so its treatment should be comprehensive and include a variety of medications. We will now tell about them.

The list of medicines that help to relieve an attack of the disease
Medications for treatment outside the attack of arthritis
Folk remedies
Diet - your main assistant + video

If gout is detected for the first time, then for the primary diagnosis of this disease and the appointment of competent treatment,to undergo in-patient treatment in the rheumatological department of the hospital.

Usually, in order to go through all the necessary examinations, put an accurate diagnosis and appoint a suitable treatment, doctors need one to two weeks, which, by and large, is not such a long time. But in the future, gout treatment can be performed on an outpatient basis, under the supervision of a rheumatologist or nephrologist. They will prescribe medications that will help stop the disease and reduce pain in the joints.

The main group of drugs for treating gout

Since the main manifestation of gout is an attack of acute gouty arthritis, accompanied by severe pain in the leg, the entire treatment of gout and the medications used for this can be divided into two broad groups: medications for arresting an attack of gouty arthritis and drugs fortreatment of this disease outside seizures - in a relatively quiet period.

Drugs that help to relieve an attack of the disease

Colchicine and non-steroidal anti-inflammatory drugs( NSAIDs) are used to relieve pain with specific arthritis caused by gout and to relieve concomitant inflammation.

Colchicine

colchicine

Colchicine is a special substance isolated from plants, the main feature of which is to stop cell division. Therefore, it is called a cellular poison. Of course, this does not mean that it is a poison for a person, but it is a strong enough drug, which, like any other medicine, has side effects.

Colchicine well helps relieve pain and inflammation in gouty arthritis. It is usually prescribed at the height of the attack, every hour for half a milligram of this drug or one milligram every two hours. In this case, the doctor closely follows the patient's condition, since colchicine has many side effects, when the appearance of which the drug must be canceled.

This medication is continued until:

  • does not improve the patient's condition and the attack is stopped;
  • will not have any side effects( usually from the gastrointestinal tract) - in this case colchicine is canceled and other medicines are prescribed to stop inflammation and pain( hormonal and non-steroidal anti-inflammatory drugs);
  • the total dose of the medicine taken will not reach six milligrams, and the effect of treatment will not arise;in this case, we can assume that the drug did not work, and this patient needs another remedy.

Sometimes, in order to avoid strong side effects from the stomach and intestines, the doctor can prescribe the introduction of colchicine intravenously. In this case, since this agent has a strong irritant effect on the tissue adjacent to the vein, this intravenous administration is extremely slow and under the supervision of the doctor. It can take up to several minutes, and this is normal.

Non-steroidal anti-inflammatory drugs( NSAIDs)

If colchicine does not work, has severe side effects, or for some other reason, to stop an acute attack of arthritis with a gout doctor may be prescribed medications from a completely different group - nonsteroidal pain medications. These include drugs such as naproxen( sanaprox, nalgezin-forte, aliv, apranax), all known indomethacin( methindol, indocid, inddeene, indotard) and other NSAIDs. Initially, indomethacin for an acute attack of gouty arthritis is prescribed in a certain dose, after which every 6 hours, another amount of the drug is taken. What is characteristic, the earlier the intake of indomethacin in the attack of gout began, the faster it is possible to stop the attack. After a day, against the background of the drug effect, the dose is gradually reduced.

Please note: the names of the drugs and their doses are indicated for information purposes only! Do not try to self-medicate, this can lead to unpredictable consequences! If you have symptoms of an acute attack of gout, always consult a doctor!

Hormonal medications( glucocorticoids)

interrupting gout attack help to inject hormones into joint area

If treatment of an acute attack of arthritis caused by gout with colchicine or non-steroidal anti-inflammatory drugs did not lead to the desired result, the use is "heavy artillery": the doctor appointshormonal agents that reduce inflammation - the so-called glucocorticoid hormones.

The doctor can use single injections or short courses of drugs such as betamethasone and methylprednisolone for this. The use of such drugs can certainly reduce arthritic inflammation with gout and relieve the pain.

Since an attack of arthritis with gout gives a pronounced inflammation in the joint and pain, it is very important to stop such an attack as quickly as possible. Usually, in order to interrupt this inflammation, it takes no more than two days.

Medications to treat an attack

After an acute attack of gouty arthritis is lifted and the diagnosis is made, it's time to think about what to do next. There are special preparations for the treatment of gout in out-of-impulse periods( which, by the way, do not work during an attack).Let's talk about them.

Purinol( allopurinol)

Because gouty arthritis is a disease in which deposits of uric acid salts accumulate in the tissues in excess of accumulating in the body, the doctor prescribes medicines for its treatment that enhance the excretion of urate from the body.

These drugs include purinol or allopurinol. During an attack of arthritis, these drugs do not work. It is understandable, because purinol does not affect pain and inflammation.

But if after the first attack to take treatment with purinol, then the likelihood of repeated attacks is significantly reduced - up to the fact that a year later, in an even disease, the doctor may even suggest that you gradually give up this medication.

Of course, the decision to abolish therapy should only be made by a doctor based on your condition and test data. Independently to cancel treatment in no event it is impossible!

Folk remedies

treatment of gout with folk medicine: only under the supervision of a doctor!

Generous nature is rich in medicinal plants that help from a variety of ailments;there are herbs on the basis of which you can prepare medicinal tinctures, lapping and compresses, helping to improve well-being and gout.

More about them you can read in the article People's treatment of gouty arthritis.

Just remember that the use of medicines based on folk recipes, from whatever reliable sources they do not appear, must necessarily be agreed with the attending physician and should not be used instead of medical treatment, but with it!

Diet

Are surprised? Yes, a diet can also be a cure! And if it is a question of such an exchange disease as gout, then the right therapeutic diet may well be the main assistant in recovery. It is compliance with the diet for gout that makes it possible to control this disease and avoid bouts of the disease in the future.

red meat is the most harmful product in the diet for gout

The main principle of therapeutic nutrition for gouty arthritis is to avoid foods that contain a large amount of urate or substances that can turn into urates inside our body( products with a high content of purine bases).

Meat, especially lamb and veal, as well as meat by-products( liver, kidneys), meat broths and soups, cold meat, some types of fish( mackerel, sardines, herring), as well as alcohol, are primarily related to such food products. However, products such as pasta, bread, milk and its derivatives, cheeses can be eaten without restrictions.

Actually, only compliance with a diet with this disease can help to forget about this disease with time, so it's worth taking this information with special attention. For more information on how to eat properly in this disease, we wrote in the article Diet and therapeutic nutrition for gout.

As you can see, in order to defeat gout, not so many medicines are required. The main thing that is important in this disease is not to engage in self-medication, in time to see a doctor and observe the prescribed diet.

Stay healthy!

ArtrozamNet.ru

Gout: new in the treatment of this disease

Gout is a disease in which an excess of uric acid salts( urates) is formed in the human body. This disease makes itself felt through attacks of gouty arthritis in the patient, which cause discomfort and periodic pain, especially when walking. The main hint of this ailment is the formation of tofusov( special nodules located near the joints).

Who is most susceptible to gout?

It is generally believed that gout is a male disease, because according to statistics, women rarely complain of joint disease, but in the modern world, the percentage of those infected with gout aligns the border between the female and male sex.
The disease comes with age. The average age of the male patient is 45 years, the female age is 55. When the menopause comes, the body's uric acid content increases, which provokes gout.

There is an opinion that gouty arthritis can be caused by a hereditary predisposition.

For example, if someone from the next of kin has suffered the disease and you are a man, this puts you at risk for developing gout. An incorrect way of life can affect the rapid development of this disease. In the United States, the proportion of people suffering from gout is significantly higher than in Russia, about 3 times.

Causes of gout:

  1. Bleeding.
  2. Results of surgical intervention.
  3. Infectious diseases.
  4. Prolonged use of certain heavy drugs.
  5. Excessive physical activity. Injuries to joints and bones.
  6. Abuse of bad habits, especially alcohol.
  7. Incorrect power.

Gout is a disease that is directly related to metabolism in the body. That is why the risk of getting sick is higher among those who take foods that contain too many purines. Or, for some reason, it is difficult to release purines from the body. For example, as a result of another disease. Often, gouty arthritis appears as an additional disease.

Which products contain many purines?

Because gout is often called a disease of meat eaters, it is easy to guess that it is the excessive consumption of meat and by-products that can provoke the disease.

Products containing purines:

  1. Meat and offal.
  2. Various legumes.
  3. Cocoa.
  4. Tea.
  5. Alcohol: especially beer and red wine.
  6. Some fish species.

People who consume the above products in large quantities are usually patients with a diagnosis of gouty arthritis. In a normal healthy body purines come out of the body, but do not remain. Therefore, gout develops in those who can have problems with the kidneys. Excess acid begins to be deposited in the human body, tissues in the region of the joints or in the kidney canals.
If a person takes heavy medications to eliminate a serious illness, then these drugs can give complications to the kidneys, which will make it more difficult for uric acid to escape. This will cause the development of a new disease - gout.

Symptoms of gout

After a regular meat meal with alcohol, a person may have a gout attack. As a rule, it occurs at night. It appears as a sharp acute pain in one of the joints.

In translation from ancient Greek gout means "trap for the leg."This is why the joints of the legs most often suffer, especially the area of ​​the thumb. The knee or elbow joint may also be affected. The affected area begins to swell and hurt, the skin turns red. The body temperature of this area is significantly increased.
If you do not treat an attack, it can last several days or weeks, but, as a rule, the patient immediately consults a doctor. If you start treatment in time, you can get rid of gout. The heavier the patient's condition, the longer the treatment will be.

Tofusi with gout

Gouty arthritis attacks are considered as a disease that was acquired by a person due to malnutrition, a bad lifestyle or any other cause. But the presence of tofusi indicates that gout is a hereditary disease.
Excessive amount of salts in the body should go away. If it does not come out, then they form small nodules on the joints - tofusi. They are visible to the naked eye. If the body has such nodules, then this is cause for concern and an immediate visit to the doctor. Since in this case the disease can develop for a long time and do not make itself felt until the number of nodules does not complicate the bleeding.

Treatment of gout

The most popular therapies are various medications. For example, hormones and colchicine.

Colchicine is a drug that can reduce pain in an acute gouty fit.

This tool gradually restores the function of the affected joint. The drug is prescribed by a doctor. It is used according to the instructions: every few hours for several days, until the pain disappears. Then the treatment goes to another stage.
It happens so, but very rarely, that colchicine did not produce an effective result. In this case, glucocorticoids are prescribed. To this group are medicines: betamezaton and methylprednisolone. These drugs are found in the form of a prick in the affected joint in place of a doctor.

Treatment of one attack is just the beginning. Complex therapy is considered a good result.

Modern methods of treating gout

Methods of treating gout. Most of them are medicamentous. For the beginning, the patient's condition is diagnosed. Analyzes should show the level of acid in the urine. Then appropriate therapy is prescribed.

The most popular therapies:

  1. A strict diet under the supervision of a doctor.
  2. Medication intervention.
  3. Physiotherapy.

Quick help for gout at home

If the patient is waiting at the doctor's house and does not have the necessary medication to take off the pain, then an ice cube is ideal.
He can also brew a rose hip tea. By the way, rosehip is able to remove excess amount of acid from the body, so it is ideal for prevention.

Modern methods in the treatment of gout use colchicine( the best modern remedy), which was mentioned above, but this drug has a number of complications. The fact that it causes vomiting, nausea, stomach cramps and diarrhea, as it is very toxic. He is categorically forbidden with purulent infection, alcoholism, kidney failure and in old age. When drug treatment methods do not work, the doctor injects drugs.

What do they offer us today as a cure for gout?

Medicine does not stand still and constantly creates something new. Doctors perfectly understand that all medicamental methods for the first few days remove only the symptoms and eliminate the pain, that is, the disease progresses further. But with further treatment, drugs begin to remove the level of uric acid in the blood. This acid is so strong that it can destroy joints. It is the poet who always needs to go to the toilet in a timely manner and not to contain urine, since a poisonous acid can in time give complications not only to the joints, but also to many other vital internal organs.
New drugs in the treatment of gout are less toxic and most effective in controlling seizures.
For example, in combination with colchicine, which is necessary at an early stage of a gouty attack, there may be an effective tool - apopoupherin. It is ideal for patients in the treatment of gout, which suffer from kidney stones.

The fact that modern drugs, although they are less toxic, but they still contain the poison, although in much smaller proportions.


For example, apopopurinop is able to cause a rash on the body at first. In addition, it quickly begins to get used to. A side effect is drowsiness. This drug is very carefully assigned to drivers. In combination with colchicine, it completely blocks the risk of new seizures.
Appopurinop is also used for various cancers.

Colchicine relieves swelling, pain and attack, and apopopurin lowers the level of uric acid. Modern drugs aimed at treating gout, relieve some of the symptoms, but all this must always be combined with physiotherapy and proper diet. Often patients are prescribed a sanatorium rest.
About what drugs reduce the level of uric acid in the blood, scientists study in the field of pharmacology.

Diet for gout

In fact, it is very difficult to name any disease in which proper nutrition plays a small role. Therapeutic diet is the first thing that a doctor appoints to treat gout, as this is the most important element of recovery.
In this case, for gout, the diet plays the most important role. Even after using medicines, if you adhere to the diet prescribed by the doctor, you will notice that the disease recedes and there is no point in taking the pills further. Maintaining a diet for gout is not easy, since most delicious foods will have to be abandoned. Since the disease most often arises from the abuse of dangerous products, it is extremely difficult to refuse them to the patient. Nevertheless, if you prioritize your health, then you must abandon the following products:

  1. Red meat and all products from it. Meat by-products( heart, liver, kidneys and much more).
  2. Different fat types of fish.
  3. Sharp and salty cheeses.
  4. Refuse salt completely or maximally reduce the amount of its use.
  5. Alcoholic beverages, namely champagne, beer, cognac and dessert sweet wines.
  6. Bean cultures.

The doctor will make a more detailed diet. In addition, gout is a disease that is well treated by various folk remedies. The most effective and best tool in the treatment of gout is in grandmother's scrapbook. For example, a specially prepared tincture of rose hips removes slag, excessive cholesterol and uric acid from the body. Even modern treatment suggests this.

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Gout remedy stops the development of the disease

Treatment of gout in modern ways

There are many methods of treating gout, but first of all, the level of uric acid in the blood is determined and the degree of involvement of other internal organs is determined. When prescribing medicines, for example, it is important to know whether the kidney function is impaired and whether there are any stones. The main methods are as follows:

  • diet,
  • medication,
  • physiotherapy.

The first step is the removal of pain in the joints. To do this, the level of uric acid in the blood decreases. The first quick and independent help can be done at home. For this, the patient with his suffering joint is laid in bed to ensure complete rest. The joint is fixed on a hill( pillow, roller) and an ice pack is applied to it.

At this time, it is necessary to drink a lot of liquids, especially a rosehip drink, which quickly removes uric acid from the body. By directly treating the area of ​​the foot, patients often resort to the method of acupressure and acupuncture. In this way stagnation in the blood is eliminated, deposits of salts are eliminated and the tissue structure is restored.

Any treatment method is accompanied by an adjusted diet. Nutrition can prevent the occurrence or stop the development of gout, excluding excessive consumption of meat, mushrooms, salt, legumes.

deposits of urates on the joint

In modern medicine, non-steroidal anti-inflammatory drugs are used. One of the oldest and most powerful means of blocking pain is colchicine. On the drug, indeed, the body reacts very quickly in terms of alleviating the attack of gout. But, unfortunately, this drug is very toxic, can cause nausea, vomiting, stomach spasm, diarrhea. P The use of colchicine is prohibited when alcoholism, kidney failure, pregnancy, purulent infection and in old age. When non-steroidal drugs are powerless, steroid drugs are prescribed, which can act as injections.

What's new today?

In the treatment of this disease, medicine is moving forward a lot. Medications relieve gout symptoms within the first two days, and then their action is directed at preventing subsequent attacks, which is achieved by controlling the permissible level of uric acid in the blood. Today, new drugs for gout are less toxic and very effective against acute attacks. With the same colchicine, which is effective at an early stage, the use of allopurinol is well combined. This is especially good for patients with kidney stones.

At first, there may be a rash and a slight upset stomach, but there is a rapid addiction to the drug. For people working with mechanisms and driving, allopurinol is administered cautiously, as it can cause drowsiness. During an acute attack of gout, this drug is not used. In this case, we can talk about its combination with colchicine, which blocks the attack of gout, and in the future the action of allopurinol is aimed at reducing uric acid in the blood and the risk of new attacks. This drug is also used as a supporting agent in the treatment of cancer.

tablets stop gout attacks

Thus, it is seen that in the treatment of gout, two lines of therapy are allocated: one aimed at treating acute status( eg colchicine), the second - reduces the level of uric acid( until recently the only effective was considered the action of allopurinol).Now a new era - new drugs. Modern scientists in the field of pharmacology are studying which drugs can safely reduce the level of uric acid in the blood. With the development of new methods for diagnosing gout and its attendant diseases, a new treatment for gout is being identified. But the diet, physiotherapy and recommendations of sanatorium treatment remain unchanged.

Fullflex for treatment of attacks

Often when prescribing gout treatment, fullflex appears. The advantage of this drug is that it is created on the basis of herbs: martini, scented, white willow. Virtually no contraindications and no side effects. The root of martini sweets included in the pharmacopoeia countries such as France, Germany, England. He resembles a crooked hand and was called "the devil's claws."

This agent is able to bind uric acid in the blood and remove it from the body. The presence of the extract of the bark of the white willow removes puffiness, joint pain and restores their mobility. It contains salicylate, which has an anti-inflammatory effect. The drug has the form of capsules or cream, and the full price of the price is so insignificant that it is available to a patient of any social group. What is convenient is that one capsule per day is sufficient. The remedy is not a medicine, it is a dietary supplements and the only contraindications are pregnancy, breast-feeding and children under 14 years of age.

This tool is developed on the basis of modern research, is unique and reduces the cholesterol level to anything. Ointment fulflex must be applied to the painful joint and rubbed with light circular motions. This external application reduces the pain syndrome. The combination of external application with internal is considered the most effective. As a result, we get the receding gout and the adjusted work of the joints.

Gout is a chronic disease, and it is completely impossible to cure it. An ideal medicine does not exist, since tolerability of all is different and individual reaction. It is always recommended to conduct treatment under the supervision of a doctor. Self-medication is in any case prohibited, in order not to harm the joint completely.

sustavu.ru

Treatment of gout in modern ways

There are many methods of treating gout, but first of all, the level of uric acid in the blood is determined and the degree of involvement of other internal organs is determined. When prescribing medicines, for example, it is important to know whether the kidney function is impaired and whether there are any stones. The main methods are as follows:

  • diet,
  • medication,
  • physiotherapy.

The first step is the removal of pain in the joints. To do this, the level of uric acid in the blood decreases. The first quick and independent help can be done at home. For this, the patient with his suffering joint is laid in bed to ensure complete rest. The joint is fixed on a hill( pillow, roller) and an ice pack is applied to it.

At this time, it is necessary to drink a lot of liquid, especially good is a rosehip drink, which quickly removes uric acid from the body. By directly treating the area of ​​the foot, patients often resort to the method of acupressure and acupuncture. In this way stagnation in the blood is eliminated, deposits of salts are eliminated and the tissue structure is restored.

Any treatment method is accompanied by an adjusted diet. Nutrition can prevent the occurrence or stop the development of gout, excluding excessive consumption of meat, mushrooms, salt, legumes.

deposits of urates on the joint

In modern medicine, non-steroidal anti-inflammatory drugs are used. One of the oldest and most powerful means of blocking pain is colchicine. On the drug, indeed, the body reacts very quickly in terms of alleviating the attack of gout. But, unfortunately, this drug is very toxic, can cause nausea, vomiting, stomach spasm, diarrhea. P The use of colchicine is prohibited when alcoholism, kidney failure, pregnancy, purulent infection and in old age. When non-steroidal drugs are powerless, steroid drugs are prescribed, which can act as injections.

What's new today?

In the treatment of this disease, medicine is making significant progress. Medications relieve gout symptoms within the first two days, and then their action is directed at preventing subsequent attacks, which is achieved by controlling the permissible level of uric acid in the blood. Today, new drugs for gout are less toxic and very effective against acute attacks. With the same colchicine, which is effective at an early stage, the use of allopurinol is well combined. This is especially good for patients with kidney stones.

At first, there may be a rash and a slight upset stomach, but there is a rapid addiction to the drug. For people working with mechanisms and driving, allopurinol is administered cautiously, as it can cause drowsiness. During an acute attack of gout, this drug is not used. In this case, we can talk about its combination with colchicine, which blocks the attack of gout, and in the future the action of allopurinol is aimed at reducing uric acid in the blood and the risk of new attacks. This drug is also used as a supporting agent in the treatment of cancer.

tablets stop gout attacks

Thus, it is seen that two lines of therapy are allocated in the treatment of gout: one is aimed at treating an acute condition( eg colchicine), the second - reduces the level of uric acid( until recently the only effective was considered the action of allopurinol).Now a new era - new drugs. Modern scientists in the field of pharmacology are studying which drugs can safely reduce the level of uric acid in the blood. With the development of new methods for diagnosing gout and its attendant diseases, a new treatment for gout is being identified. But the diet, physiotherapy and recommendations of sanatorium treatment remain unchanged.

Fullflex for the treatment of attacks

Often when prescribing gout treatment, fullflex appears. The advantage of this drug is that it is created on the basis of herbs: martini, scented, white willow. Virtually no contraindications and no side effects. The root of martini sweets included in the pharmacopoeia countries such as France, Germany, England. He resembles a crooked hand and was called "the devil's claws."

This agent is able to bind uric acid in the blood and remove it from the body. The presence of the extract of the bark of the white willow removes puffiness, joint pain and restores their mobility. It contains salicylate, which has an anti-inflammatory effect. The drug has the form of capsules or cream, and the full price of the price is so insignificant that it is available to a patient of any social group. What is convenient is that one capsule per day is sufficient. The remedy is not a medicine, it is a dietary supplements and the only contraindications are pregnancy, breast-feeding and children under 14 years of age.

This tool is based on modern research, is unique and reduces the cholesterol level. Ointment fulflex must be applied to the painful joint and rubbed with light circular motions. This external application reduces the pain syndrome. The combination of external application with internal is considered the most effective. As a result, we get the receding gout and the adjusted work of the joints.

Gout is a chronic disease, and it is completely impossible to cure it. An ideal medicine does not exist, since tolerability of all is different and individual reaction. It is always recommended to conduct treatment under the supervision of a doctor. Self-medication is in any case prohibited, in order not to harm the joint completely.

Who was treated with fullflex?

In occasion of application of a medicine fullflex responses meet different, but unequivocally negative are not present. Mostly positive or reports that there was no significant relief:

  • "My gout has been supplying me with difficulties for a while with shoes. I could only take shoes with a square nose, but for me, lovers of elegant shoes on the heel - this is terrible flour. By the way, love for the heel and became the cause of this disease. My son brought Fulflex from Moscow, and now I am smearing not only his feet, but also his knees. I must say that the relief is significant. "
  • "At first the knuckle on the leg simply swelled, and then there was a crunch and a burning sensation. The doctor said that I had insignificant changes in joints and prescribed "Fullflex" in capsules and ointment. The knuckles do not hurt and are almost back to normal. I'm very glad that I caught myself in time. But the doctor says that for the prevention it will be necessary to periodically apply the course. "
  • "About Fullflex read on the Internet, asked his doctor, she sceptically shrugged shoulders, they say" garbage ".I bought it anyway, because I did not hear the definitive "no".Sometimes it helps, sometimes it does not. Sometimes I think that all this is better than chemising chemistry, and sometimes I treat this as a regular pumping out of money. "
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gout

Gout occurs in almost 0.25% of the population. Drug treatment is effective, but some drugs can accelerate the course of the disease.

Causes of gout

Gout is characterized by a sharp attack of arthritis caused by chronic deposition of monosodium salt of uric acid in the cartilage and kidneys, and nephrolithiasis of urates.

Urates with gout

Uric acid refers to purine bases( guanine, adeny), which are involved in the formation of nucleic acids. The amount of urate in the body of a healthy man who is on a diet in which there are no purines is 1200 mg, and in women about 2 times less. In patients with gout without visible salt deposits, the amount of urate in the body increases by 2 or 3 times compared with the norm, and since this amount exceeds that which can be in the dissolved state in the extracellular fluid, their microcrystalline deposits are formed. In patients with gouty nodes, the amount of urate in the body can be 15-26 times higher than normal. Urates are excreted mainly through the kidneys. At the same time, being bound to plasma proteins by only 5%, they are freely filtered through the renal glomeruli and then reabsorbed from the lumen of the tubules, and are also secreted into it from the blood. Urate that appears in the urine is the result of excess of their secretion over absorption. Both processes are active, require energy costs, they can be influenced by drugs.

Gout attack

To develop an attack of gout , two conditions are necessary: ​​

a) precipitation of crystals of monosodium salt of uric acid from body fluids in hyperuricemia( a detailed mechanism for starting this process is still unclear)

b) development of local inflammatory reaction with phagocytosis in response to the presencecrystals. Actively phagocytic leukocytes produce lactic acid, which contributes to the precipitation of urate into the crystals, since they are less soluble in an acid medium.

As the crystallization increases, the processes of inflammation and phagocytosis are amplified, which causes a large amount of lactic acid and self-stimulation of the inflammatory reaction. The inflammatory process is also enhanced by the enzymes involved in the digestive processes and released from the lysosomes of leukocytes.

Hyperuricemia and gout are thus caused by two major processes:

1) insufficient urate excretion as a result of primary abnormalities in the kidneys and the effects of drugs on the transformation of urates in tubules;these properties are possessed by all diuretics( except for spironolactone), acetylsalicyl acid( in small doses), pyrazinamide, nicotinic acid and alcohol( the latter increases the synthesis of urates, and also forms lactic acid, suppressing their tubular secretion);

2) excessive formation of urates caused by various defects of enzymes that enhance purine biosynthesis and excessive decay of cells with the release of nucleic acids in drug treatment or X-ray therapy in myelo- or lymphoproliferative processes.

Preparations for gout

When gout is used drugs:

a) suppressing symptoms( anti-inflammatory with analgesic action or without it, namely azaprope, diclofenac, indomethacin, naproxen, piroxicam and sulindac; colchicine, adrenocorticosteroids and corticotropin);

b) synthesis-preventing urates( allopurinol);

c) contributing to the release of urate( uricosuric substances, namely, probenicides, sulfinpyrazone).

Colchicine Colchicine is an alkaloid from autumn crocus, has antimitotic properties and is not currently used for malignant diseases, but is effective for gout, since it relieves pain and inflammation in a few hours. It is believed that such a rapid relief of the condition can serve as a confirmation of the diagnosis, since with non-hypogratic arthritis the drug is ineffective, although failure with its use does not mean that the patient does not suffer from gout. The reason for the special ability of colchicine to stop pain with gout is not established, but the most probable explanation is that it suppresses the migration of leukocytes to the inflamed area and thus interrupts the already described inflammatory cycle.

The drug is absorbed from the intestine, part of it is metabolized in the liver, and part is excreted unchanged with bile and reabsorbed from the intestine. This increases its toxic effect on the intestines.

In case of an acute attack of gout, colchicine can be prescribed for oral administration at a dose of 1 mg, and then 0.5-1 mg every 2 hours until the pain disappears or side effects appear. Improvement of the condition usually occurs after 2-3 hours and lasts for 12 hours. As a rule, the total dose is 3-6 mg, it is inappropriate to use more than 10 mg. If an effective dose is established, the patient can take her whole attack, and then at 0.5 mg after 1 hour. Colchicine has a preventive effect on gout, if taken 0.5-1 mg / day or every other day. It is also used as a primary remedy for Mediterranean fever, preventing exhausting bouts of fever and development of amyloidosis in these patients.

Adverse reactions can be severe and accompanied by abdominal pain, vomiting and diarrhea( blood may be present in the stool).Probably, they are caused by depression of mitosis of rapidly reproducing cells of the intestinal mucosa. Can develop kidney failure and sometimes blood diseases. Large doses cause muscle paralysis.

Allopurinol

Allopurinol inhibits xanthine oxidase, an enzyme that converts xanthine and hypoxanthine to uric acid. In patients taking it, less urate and more xanthine and hypoxanthine are released with urine. Both compounds are easily excreted in renal failure and are more soluble than urates, as a result of which xanthine stones are rarely formed. Allopurinol was first used in the treatment of patients with leukemia to prevent the oxidation of active b-mercaptopurine to the inactive metabolite, when its effect on the synthesis of uric acid was observed. The patient has a gout, treated with allopurinol;the usual doses of 6-mercaptopurine cause its potentiation.

Allopurinol is readily absorbed from the intestine, is metabolized in the liver to alloxanthin, which also has an inhibitory effect on xanthine oxidase. It is excreted unchanged in the form of alloxanthin through the kidneys.

The drug is recommended for renal insufficiency accompanied by urate lithiasis, or when a large number of gouty nodes are formed in blood diseases in which spontaneous hyperuricemia occurs( due to the deposition of salts around the joints) and myeloproliferative diseases, when destruction of cells leads to a large load of urate. Allopurinol prevents the development of hyperuricemia caused by diuretics. E can be combined with uricosuric means.

During the first 2 months of treatment, the risk of an acute attack of gout increases, despite a decrease in the level of urate in the blood.

This may be due to a decrease in the level of urate in the plasma or its fluctuations, which causes dissolution and, apparently, alternating recrystallization of urates from the foci of deposits in the gouty nodes. During this period, non-steroidal anti-inflammatory drugs or colchicine should be used as depressants, and the patient should be warned about the possibility of an attack, because otherwise he may be disappointed in the drug.

Single intake of 300 mg is usually sufficient for treatment, but in severe cases, the total dose can reach 600 mg or more.

Side effects, not counting exacerbations, are rare;they include a different kind of allergy, leukopenia, impaired bowel and liver function.

Uricosuric remedy for gout

Probenecid

Probenecid is available in 0.5 g form. It does not have analgesic effect. It began to be used at a time when penicillin was still difficult to access and there was a need for drugs that could prevent its active excretion by the renal tubules and thus, with the introduction of small doses, maintain a large concentration in the plasma. Probenecid provides this action, but penicillin sal is so cheap and affordable that now the same effect is achieved with increasing its dose. However, probenecid is sometimes used in infections in which an unusually high plasma penicillin level is desired, for example, in infectious endocarditis, in the treatment of children for whom frequent administration of large doses of an antibiotic is undesirable and, if necessary, obtain the maximum effect with a single administration of the drug, for example in gonorrhea.

Probenecid inhibits the transport of organic acids through the epithelium and, most importantly, through the epithelium of the renal tubules. The effect depends on the dose: small doses prevent tubular secretion and excretion of urates, but an adequate dose inhibits their reabsorption from the lumen of the tubules and has a beneficial uricosuric effect.

The drug binds to plasma proteins by 90%, partially metabolized, and is partially excreted unchanged in the urine. The half-life period varies depending on the dose within 5-8 hours.

To prevent a gout attack, the dose is 0.5 g once a day for the l-th week, then it increases to 1-2 g / day. The level of urate in the plasma is initially reduced and set, reaching 60% of the initial level. Because of the large loss of urate at the beginning of the treatment, the crystals may appear in the urine if the pH is not maintained at the level of

6.0 or more in the first month of treatment with probenecid( or another uricosuric agent, for example a mixture of potassium citrate with water of 12-24 g/ day or sodium hydrogencarbonate in the form of a powder of 5-10 g / day, washed with water).The patient should be prescribed a generous drink( 3 liters / day) to avoid the danger of mechanical obstruction or formation of stones. Urine should be made to have an alkaline reaction and be diluted;To this end, take a tablet( 250 mg) of acetazolamide at night. It should be monitored for a patient with renal insufficiency( in addition, potassium citrate can cause dangerous hyperkalemia).Probenecid in this case is contraindicated, since it may be ineffective or even aggravate the kidney disease.

In some patients, it causes a violation of the function of the gastrointestinal tract and sometimes allergies, blocks tubular excretion and prolongs the action of penicillins, cephalosporins, naproxen, indomethacin, and panylurea.

Treatment of gout

Acute attack of gout

With this form of gout, non-steroidal anti-inflammatory drugs are highly effective: the attack stops after a few hours after ingestion. It is important to begin treatment as early as possible. Indomethacin belongs to the drugs of choice;it can be taken orally 25-50 mg three times a day, for the fourth time( sometimes in a larger dose) it is taken at night. Side effects from the gastrointestinal tract develop less often if the drug is taken with food. It can be used in the form of candles( 100 mg).Naproxen, diclofenac, sulindac, piroxicam and azapropane are among the effective alternatives. With intolerance of non-steroidal anti-inflammatory drugs, colchicine is traditionally used. It can be a drug of choice for the first attack of severe monoarthritis, since its effect simultaneously helps to establish a diagnosis, which is sometimes difficult. Other anti-inflammatory drugs act indiscriminately.

If these drugs are ineffective, you can begin treatment with prednisolone at 40 mg / day with a dose reduction immediately, as soon as symptomatology allows. Cancellation of the drug can cause a relapse, so it is advisable to add colchicine in order to pass this stage.

Urikozuric drugs and allopurinol are useless in an acute gout attack.

Recurring and progressive forms of gout can be prevented by convincing the patient not to take alcohol and prescribing allopurinol and uricosuric drugs if the urate level in the plasma is above 0.6 mmol / l and the patient has already suffered three or more acute attacks of the disease.

Treatment should be started in a calm period. Usually, allopurinol is more preferable, which serves as a drug of choice in reducing renal function. It can be combined with uricosuric means. Salicylates can not be administered simultaneously with other uricosuric drugs, as they interact. Paracetamol can be used as an analgesic.

Colchicine also prevents a gout attack. It does not affect the excretion of urates.

Rapid reduction of urate levels in plasma by any method can promote an acute attack, probably due to the dissolution of salts. In this regard, in the first 2 months of treatment withallopurinol and uricosuric agents, it is recommended to carry out anti-inflammatory treatment with indomethacin in order to prevent acute attacks, while urine should be alkaline and its volume large to avoid crystalluria.

The beneficial effect caused by a decrease in the level of urate in the plasma is invisible for several weeks. It is necessary to select the preparations in such a way as to maintain the level of urate in the plasma within the limits of the norm. Neglect this is not recommended. Prevention of one colchicine or indometacin is undesirable, since urate in the urine remains at a high level, which causes the progression of the disease( the formation of gouty nodes in places of salt deposition, kidney damage).

Chronic gout with the formation of gouty nodes.

Gouty sites sometimes decrease in size and even disappear when treated with allopurinol or its combination with uricosuric agents. In acute pyrophosphate arthropathy, treatment is the same as in acute gout.

Exacerbation of gout attacks with diuretics.

Any active diuresis can contribute to an acute attack of gout due to a decrease in the volume of urine, which leads to an increase in the reabsorption of all substances, including urates, normally reabsorbed from the proximal tubules;antagonistic effect have allopurinol and uricosuric substances.

Diet, alcohol and gout

Usually, gout patients have an excess body weight, and when it decreases, the level of urate in urine decreases. However, in obese persons, gout can develop gout due to ketosis, which causes precipitation of urates in tissues( due to acid reaction);some experts recommend taking allopurinol during this period. It has long been known that alcohol induces acute attacks of gout, as it increases the formation of urates and causes lactic acidosis, which contributes to the deposition of urate in the tissues and blocking their excretion by the renal tubules.

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