The list of medicines that help to relieve an attack of the disease
Medications for treatment outside the attack of arthritis
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 inpatient 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 relieve concomitant inflammation.
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:
- the patient's condition improves and the attack is stopped;
- there will be no side effects( usually on the part of 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 taken medicine 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, gave strong side effects or for some other reason to stop an acute attack of arthritis with gout doctor can be prescribed medications from a completely different group - non-steroid 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)
interrupt 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 such drugs 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 this 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.
Because gouty arthritis is a disease in which deposits of uric acid salts accumulate in the tissues, accumulating in the body excessively, 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 probability of repeated attacks significantly decreases - 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!
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 details about them you can read in the article National 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!
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 number of urates or substances that can turn into urate inside our body( products with a high content of purine bases).
These foods primarily include meat, especially lamb and veal, as well as meat by-products( liver, kidneys), meat broths and soups, cold meat, some fish species( mackerel, sardines, herring), and alcohol. However, products such as pasta, bread, milk and its derivatives, cheeses can be eaten without restrictions.
In fact, only compliance with a diet with this disease can help in time to almost forget about this disease, 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 medications 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.
Causes, symptoms and treatment of gout on the legs
What is gout?
Gout is a metabolic disease in which salts of uric acid( known as urate) are deposited in the joints. Gout is otherwise called "disease of kings", an ancient disease that was known even in the time of Hippocrates. Now gout is considered a rare disease, it affects 3 people out of 1000. And most often it affects men over the age of 40, in women it is most often manifested after menopause. Gout itself is one of the types of joint diseases caused by the deposition of salts.
All gums suffer from gout, ranging from the joints of the fingers to the toes of the toes.
It was known even in the time of Hippocrates and is called "disease of kings" because the main source of its occurrence is immoderation in food and alcoholic beverages. Gout is often chronic.
Causes of gout
The cause of gout is an increased and persistent level of uric acid in the blood. During the course of the disease, urate crystals( a derivative of uric acid) are deposited in the joints, organs and other body systems. Sodium urate crystallizes and small particles are deposited in the joints, which ultimately leads to partial or complete destruction of the joint. For the same reason, such situations are called microcrystalline.
A large amount of uric acid in the body can be for two reasons: the first reason is when healthy kidneys can not cope with the withdrawal of an unusually large amount of uric acid, the second reason is when uric acid is released in normal amounts, but the kidneys are unable to remove it.
Every year, gout is getting more and more. Doctors explain this phenomenon by the fact that in recent years people are more likely to consume food rich in purines( for example, meat, fatty fish) and a huge amount of alcoholic products. This is confirmed by the fact that during wars the percentage of people suffering from gout fell sharply due to the fact that meat products, and, especially, alcohol, it was very difficult to get.
Symptoms of gout
The symptom of gout is a common attack of gouty arthritis - it is usually an inflammation of one joint, most often it turns out to be the joint of the big toe, knee or ankle. Usually, a gout attack occurs in the early morning or at night, it manifests itself in the form of unexpected severe pressing pain in one or another joint, the affected joint swells up, the temperature in the joint area rises, the skin turns red and starts to shine. Usually during the day the pain becomes a little less, but by the night it again intensifies, the duration of a gout attack lasts from two to three days to a week, sometimes more. With a repeated attack in this inflammation, other joints may be involved, this can lead to partial destruction of the joint.
Signs of gout is the appearance on the hands or feet of unusual growths, while the level of uric acid is significantly increased. When growths, in other words, tofusi burst, a person can see whitish crystals of uric acid. The patient can feel quite intense pain in the affected areas. Such salt deposits in the joints interfere with a full life.
Possible complications of
The main and most severe complication of gout is the appearance of gouty arthritis, it is also possible the occurrence of urolithiasis, in which the resulting stones consist of urate or crystallized uric acid.
Gouty nodes , also called "tophi" - it's nothing more than conglomerates of sodium urate crystals that have the ability to be deposited in all parts of the body. And in cases where such deposits get stuck in the joints or periarticular tissues, the immune response occurs, as these deposits are perceived by the body as a foreign body, which causes the accumulation of leukocytes and begins a strong inflammation called gouty arthritis.
It is worth paying special attention to the fact that the kidney stones that arise during gout can become the main cause of kidney failure and can eventually lead to death.
Pain with gout
You can understand the beginning of gout by sudden pain in the joint. They are accompanied by severe redness, swelling and heat."Burn" can not only hit the place, but also the area of the body in the immediate vicinity. At the same time, the body temperature can rise to 39-40 degrees. Symptoms in most cases develop within an hour. Most often, this affects the big toe. Ordinary pain medications, such as aspirin, will not help.
Pain, as a rule, begins at night and becomes, in practice, unbearable. In the daytime there is often some improvement, the pain recedes, but do not think that everything has passed. Such acute symptoms can torment the patient for about a week.
Gout in men on legs
Gout is a chronic disease. Cure it completely impossible. This ailment often manifests itself on the feet. After the onset of the disease, the symptoms may recur after six months or a year. The disease can go into a dormant state, but, without any doubt, will make itself felt. With each attack, the time between them will be reduced. Gout will return to the person more and more often.
Damaged places on the feet are often destroyed more and more, the disease can affect the neighboring joints. With a long illness over time in the affected areas, under the skin may appear peculiar hillocks, which are called "gouty nodes" or "tofusi."
This is due to the fact that the body begins to perceive large salt deposits in the joints on the legs as a foreign body, the immunity begins to inevitably react - to accumulate leukocytes, after which a strong inflammation begins. Sometimes tofusov burst and out of them stand out whitish dust - crystals of uric acid.
Often gout develops in old age. In men, it occurs much more often and at an earlier age. The male population is susceptible to this disease by the age of 40.It should be noted that women begin to suffer from gout closer to 55, mainly after menopause, when the amount of estrogen, female hormones, is sharply reduced in the body. Children and young guys are practically not prone to gout. There are rare exceptions, in cases of hereditary impairment of uric acid metabolism.
The role of uric acid in the development of gout
This disease severely impairs metabolism. Purines enter the human body with food, but they are also produced by him. Next, purines are split into uric acid, which is excreted by the kidneys. In people with gout, the content of this uric acid is much higher than normal. Excess uric acid is deposited in those tissues where there is no blood supply. There, crystals are easier to gain a foothold.
The joints, cartilage and tendons are the most affected. As a result of this disease, not only these places, but also the kidneys suffer. Most often with gout develops urolithiasis, with a lower probability of the patient may suffer from renal colic.
This can occur for two reasons: if the uric acid is produced too much and the kidneys do not cope with the output volume, so it must be deposited in the human body. And the second reason is that the amount of uric acid is normal, but the kidneys can not remove it.
However, overestimated uric acid in the body is not the only cause of gout. Here, several other factors play a decisive role: excessive nutrition, fatty food, overweight, sedentary lifestyle and hereditary predisposition.
What should I do if I have an acute gout attack?
Even with the recommendations, an acute attack will not take place instantly. But this will significantly reduce the time during which the disease will torment the person. Mainly you need to observe strict bed rest. Painful limbs are best kept in an elevated position, for example, to lay a pillow under them.
In case of intolerable pain, ice can be applied. Then it is desirable to make a compress on a sore spot with Vishnevsky ointment or dimexide. In the intake of food, it is better to restrict yourself, you can use liquid porridge and vegetable broth. But drink is worth as much as possible alkaline drinks, for example, a decoction of oats, jelly, milk, mineral water or plain water, but with the addition of lemon juice( lemon juice dissolves uric acid deposits with rheumatism and gout).You need to drink at least 3 liters a day.
Any painkillers will not help. You can take modern anti-inflammatory drugs without steroids. If you took any preventive measures prescribed by your doctor, then the procedure should be continued.
Preventing exacerbations of gout
Most often gout appears in places where the joint was injured. Therefore, treat such places with caution. Do not wear narrow and uncomfortable shoes, as it can severely damage the big toe, which so "loves" gout. Mainly to prevent the onset of gout attacks, diet and balanced nutrition are used.
The way of life will have to be completely re-examined, make it healthy. You should reconsider your taste preferences. Recommended diet number 6, which helps reduce the body's uric acid and urate. Strictly limited, or even excluded, products containing urine bases - the main source of urate. But poor purines, and therefore allowed milk, cheese, eggs, vegetables, fruits and cereals will not leave you hungry. The patient's diet should contain whole grains, eggs, vegetables, fruits, dairy products with a low fat content.
In food should restrict the intake of meat, fish, caviar, mushrooms, legumes. In addition, you need to limit consumption: smoked meat, marinade, anchovies, cauliflower, asparagus, sorrel, chocolate. Such a diet will lead to normalization of body weight and significantly reduce the burden on the joints during an exacerbation of gout.
Details of what you can eat and what not, as well as other features you can find here
Alcohol and smoking inhibit the excretion of uric acid from the body. Consequently, its crystals are more deposited in the joints. For prevention, alcohol should be completely excluded, especially beer, and also quit smoking. It is not recommended to drink tea, coffee, cocoa. In addition to dieting, it is worth doing at least once a week a fasting day with the use of a mono-product.
First of all, small joints are affected. Therefore, it is worth paying special attention to the development of their mobility. Attention should be concentrated on those sites where there are attacks of pain. Daily it is necessary to do gymnastics for joints. At first, it will be unusual, because the joints are harder to be mobile because of the deposits. It is recommended to be more often on air and to make walks.
Mineral water for gout
Mineral waters perfectly contribute to the removal of unnecessary purines from the body. Prefer alkaline and organic substances. They can be attributed primarily to Narzan, Essentuki and Borjomi. Remember that any liquid should be consumed at least 2.5 liters per day.
Treatment of gout
The diagnosis of "gout" means that a person will have to significantly change his lifestyle and constantly take medicines, because it is unfortunately impossible to achieve a complete cure for this disease. However, timely treatment starts allows you to take gout under control, reduce painful attacks to a minimum and hedge against serious complications.
The main principle of treating gout is to control the level of uric acid in the body. For medical treatment should contact a doctor-rheumatologist. Its prescriptions will be aimed at reducing the volume of uric acid and its rapid removal from the body. Only a qualified specialist can prescribe medications that, with possible concomitant diseases, do not cause the greatest harm to health.
Most often, doctors prescribe for non-steroidal anti-inflammatory drugs for 1-2 weeks, such as methindol, diclofenac, butadione, indomethacin, naproxen. To quickly reduce the concentration of uric acid in the body, allopurinol, orotic acid, thiopurinol, hepatocatalcil, milurite can be discharged. To stop acute signs of gout, doctors recommend taking colchicine.
Drug therapy for gout is aimed at solving two main problems:
The earlier a patient undergoes a test, reconsiders his habits and proceeds to treatment, the greater the likelihood of achieving a stable remission. Without adequate therapy, gout rapidly progresses, especially in patients of mature and advanced age, therefore, it is by no means impossible to reason on the principle of "caught-let-go".
Drug therapy for reducing uric acid level
Since the cause of gout is precisely the excess of uric acid, the solution of this problem in 90% of cases leads to the cessation of attacks of excruciating pain and allows you to count on a comfortable life in the future.
To reduce the level of uric acid in the body, the following drugs are used:
Allopurinol is a synthetic analogue of hypoxanthine. This substance inhibits the activity of the enzyme xanthine oxidase, responsible for the transformation of human hypoxanthine into xanthine, and then xanthine to uric acid. Thus, Allopurinol reduces the concentration of uric acid and its salts in all body environments, including blood, plasma, lymph and urine, and also promotes the gradual dissolution of already accumulated urate deposits in the kidneys, soft tissues and joints. However, this drug has a number of serious side effects and greatly increases the excretion of xanthine and hypoxanthine with urine, therefore Allopurinol is contraindicated in patients with severe renal failure. Nevertheless, for the majority of patients with gout, it remains to this day a preparation of the first order. Cost: 80-100 rubles per packing 30-50 tablets;
Phoebusostat( Ulorik, Adenurik) is a selective xanthine oxidase inhibitor that, unlike Allopurinol, does not affect other purine and pyramidal enzymes of the human body, besides it is excreted not by the kidneys, but by the liver. Phoebusostat is a relatively new drug for the treatment of gout, it is not produced in Russia, and in Western Europe and the United States it has undergone numerous clinical trials and has shown excellent results. Febuksostat for three months completely dissolves accumulations of crystals of salts of uric acid in the region of fingers and elbows and effectively prevents their repeated formation. Can be used by patients with concomitant renal pathologies. It costs a drug not cheap - an average of 4500 to 7000 thousand rubles, depending on the country of origin;
Pelotitis( Pegloticase, Krystexxa) is an infusion solution of enzymes that rapidly dissolve urate crystals( deposits of uric acid salts).It is used intravenously twice a month to stabilize the condition of patients with severe gout, which are not helped by traditional drugs. Anaphylactic shock is possible during the procedure. This is a very expensive drug that is produced exclusively abroad and is sold on order;
Probenecid( Santuril, BeneMid) is a drug that prevents re-absorption of uric acid in the renal tubules and enhances its excretion in the urine. Probenecid was originally used in complex antibacterial therapy to reduce the damage to the kidneys with antibiotics. But then it began to be prescribed for chronic gout and hyperuricemia( increased uric acid in the blood).It is important to understand that Probenecid enhances the excretion of uric acid, rather than suppresses its synthesis. Therefore, the treatment of gout with this drug is advisable only at the stage of remission. If you prescribe Probenecid to a patient with an acute inflammatory process, this will lead to active dissolution of already accumulated urates, an increase in the level of uric acid in the plasma, and, as a result, to attacks of excruciating pain. To avoid this risk, the first months of treatment with Probeecid gout are accompanied by additional hormonal and anti-inflammatory therapy. It costs a drug from 3500 to 7500 rubles.
Treatment of gout with decongestants and analgesics
Symptomatic treatment of gout is to stop seizures, relieve edema and pain, and is performed with the following drugs:
Colchicine( Colchicum, Colchimine) is an alkaloid, is released from the poisonous plants of the Melantie family. The most common source of colchicine is autumn autumnal. Colchicine inhibits the formation of leukotriene, stops the cell division of granulocytes, prevents the movement of leukocytes to the focus of inflammation and prevents urates( salts of uric acid) from crystallizing in the tissues. This drug acts as an emergency aid, and is recommended for admission in the first twelve hours after the onset of an acute attack of gout. It is necessary to drink immediately two tablets of Colchicine, an hour later - another, and then one tablet three times a day for a week. The drug very often causes unwanted reactions from the gastrointestinal tract - nausea, vomiting, loose stools. The average price of Colchicine in pharmacies is from 1,000 to 2,000 rubles;
Glucocorticoids( Cortisone, Hydrocortisone, Prednisone, Prednisolone) are synthetic analogues of human corticosteroids, that is, hormones produced by the adrenal cortex. Preparations of this group break the chain of natural reactions of the body to the interference of allergens, chemicals, bacteria, viruses and other foreign elements. Glucocorticoids quickly stop inflammation, but suppress immunity, so hormonal treatment of gout is advisable only if the expected benefit exceeds the potential risk. The cost of synthetic steroid hormones varies from 30 rubles( the oldest drug is Prednisolone), up to 1500 rubles( Cortisone);
NSAIDs( Aspirin, Analgin, Diclofenac, Ibuprofen) - Non-steroidal anti-inflammatory drugs are called so in order to emphasize their difference from hormones. However, the action of drugs in this group is somewhat similar to that of glucocorticoids. NSAIDs are non-selective inhibitors of cyclooxygenase, the enzyme responsible for the synthesis of thromboxane and prostaglandins. Thus, these drugs also suppress inflammation, but, unlike synthetic corticosteroids, do it more slowly, and are not immunosuppressants. For symptomatic treatment of gout, Diclofenac and Ibuprofen are most often used, the average cost is 10-30 rubles, the price of a popular generic( drug with the same active substance) Nurofen can reach 150 rubles.
How to prevent gout attacks?
To minimize the risk of new gout attacks, follow a few simple rules:
If possible, do not subject the joint to any load, periodically fix it in a raised position and apply ice for 15-30 minutes 2-3 times a day until the painsubsides;
Do not overuse aspirin, which can cause a jump in uric acid levels in the blood and aggravate the symptoms of gout;
Regularly measure the level of uric acid - it should not exceed 60 mg / l;
Every day, devote more than half an hour to physical education: walk, ride a bike, jog, dance, swim. In the morning, do exercises. Regardless of age and weight, patients with gout should give themselves daily physical exercise - sport works with gout more effectively than any medicine;
Drink at least two liters of clean water a day. So that the kidneys can excrete uric acid from the body, they need water first of all - not the liquid that the kidneys still need to filter( coffee, tea, juice), namely pure water. Without enough water, even healthy kidneys can not cope with the cleansing of the body;
Hand over the blood test to determine the level of the most important minerals and vitamins, and, if necessary, supplement the diet with a good vitamin and mineral complex. It is especially important for patients with gout to provide themselves with vitamin C;
Do not drink carbonated drinks with sodium benzoate and powdered juices with fructose, completely discard alcohol;
Revise your diet in favor of vegetables, fruits and cereals, eat no more than 120 grams of animal protein a day, avoid offal and fatty sausages.
On the topic: From the pains of gout can also see popular folk remedies
The newest data on the treatment of gout
CAS No.: 15687-27-1
Characteristic: A racemic mixture of R and S enantiomers. White or off-white crystalline powder, practically insoluble in water, highly soluble in organic solvents( ethanol, acetone).
Pharmacology: Pharmacological action - anti-inflammatory, analgesic, antipyretic. Non-selectively inhibits two isoenzymes of cyclooxygenase( COX-1 and COX-2), reduces the synthesis of PG.About 80% of the ingested dose is rapidly absorbed. C_max is generated after 0.5-1 h. Binding to plasma proteins is 99%.Slowly penetrates into the joint cavity, but it lingers in the synovial tissue, creating in it greater concentrations than in the plasma. Biological activity is associated with the S-enantiomer. After absorption, about 60% of the pharmacologically inactive R-form is slowly transformed into an active S-form. Undergoing biotransformation. There are 3 main metabolites excreted by the kidneys. Unchanged in the urine excreted not more than 1%.It has a two-phase kinetics of elimination from T_1 / 2 2-2.5 h( for retard forms - up to 12 h).The anti-inflammatory effect is associated with a decrease in vascular permeability, an improvement in microcirculation, a decrease in the release of inflammatory mediators( PG, kinin, LT) from the cells and the suppression of energy supply of the inflammatory process. Analgesic effect is due to a decrease in the intensity of inflammation, a decrease in the production of bradykinin and its algogenicity. Reducing the excitability of the heat-regulating centers of the intermediate brain is resultant in antipyretic action. In rheumatoid arthritis it affects mainly the exudative and partly the proliferative components of the inflammatory reaction, has a quick and pronounced analgesic effect, reduces puffiness, morning stiffness and limited mobility in the joints. With a single admission, the effect lasts up to 8 hours. With primary dysmenorrhea reduces intrauterine pressure and the frequency of uterine contractions. Has an antipyretic effect, the severity of which depends on the initial body temperature and dose. Reversibly inhibits platelet aggregation.
Indications for use
Usage: Rheumatoid arthritis, reactive synovitis with deforming osteoarthritis, psoriatic arthritis, acute articular attack with gout, ankylosing spondylitis( Bechterew's disease), cervical spondylosis, Barre-Liuu syndrome( cervical migraine, vertebral artery syndrome), lumbargia, sciatica, thoracic radicular syndrome, bursitis, tendovaginitis, myalgia, neuralgic amyotrophy, occipital and intercostal neuralgia, sprains, hematomas, trauma, pain in the operative regionionic wound, toothache, surgical operations in the oral cavity, panniculitis, tonsillitis, pharyngitis, laryngitis, sinusitis, rhinitis, bronchitis, pneumonia, pelvic inflammatory processes, dyscalgomenorrhea, colds, acute respiratory infections, febrile conditions, postural hypotension with antihypertensive medication,nephrotic syndrome( to reduce the expression of proteinuria).
Contraindications: Hypersensitivity, gastric and duodenal ulcer in the acute phase, ulcerative colitis, "aspirin" asthma, leukopenia, thrombocytopenia, hemorrhagic diathesis, severe liver and kidney dysfunction, portal hypertension, arterial hypertension, heart failure,diseases of the optic nerve, scotoma, amblyopia, violation of color vision, the last trimester of pregnancy.
Side effects of
Side effects: Dyspeptic disorders( nausea, heartburn, anorexia, vomiting, epigastric discomfort, flatulence, diarrhea, obstipation), erosive and ulcerative gastrointestinal lesions with signs of gastrointestinal bleeding, headache, dizziness, tinnitus, insomnia, agitation, visual impairment( blurred vision, change in color vision), fluid retention, edema, increased blood pressure, thrombocytopenia, granulocytopenia, hemolytic anemia, Quincke's edema, bronchial obstructive syndrome, skin allergic pections. Interaction: Reduces antihypertensive activity of ACE inhibitors, natriuretic - furosemide and hypothiazide. May increase the toxicity of methotrexate and lithium preparations. When combined with the use of anticoagulants coumarin type and alcohol increases the risk of hemorrhagic complications, with tableted glucocorticoids - the risk of gastrointestinal bleeding. Increases the concentration of digoxin in the plasma. Caffeine increases the analgesic effect of ibuprofen. Overdose: Symptoms: abdominal pain, nausea, vomiting, retardation, drowsiness, depression, headache, tinnitus, metabolic acidosis, coma, acute renal failure, hypotension, bradycardia, tachycardia, atrial fibrillation and respiratory arrest. Treatment: gastric lavage( only within the first hour after administration), activated charcoal( to reduce absorption), alkaline drink, forced diuresis and symptomatic therapy( correction of KHS, AD, gastrointestinal bleeding).
Dosage and method of application
Dosage and administration: Inside, after meals, adults 400-600 mg 3-4 times a day. With rheumatoid arthritis - 800 mg 3 times / day. Children over 12 years of age - 20-40 mg / kg in divided doses( 3-4 times a day);to reduce the body temperature of 39.2 ° C and above - at a rate of 10 mg / kg, if the temperature is below 39.2 ° C - 5 mg / kg. With dysmenorrhea - 400-600 mg with an interval of 4-6 hours External apply for 2-3 weeks. The gel or cream is applied to the affected area 3-4 times a day. Sublingually, keep in the mouth until completely absorbed. Adults and children over 12 years of age - 200-400 mg 2-3 times a day( not more than 1.2 g / day).Precautions: Given the possibility of development of NSAID-gastropathy, with caution appoint elderly people in the presence of an anamnesis of stomach ulcers and other gastrointestinal diseases, gastrointestinal bleeding, with simultaneous therapy with glucocorticoids, other NSAIDs and for long-term therapy. When symptoms of gastropathy appear, careful monitoring( including esophagogastroduodenoscopy, a blood test with determination of hemoglobin, hematocrit, analysis of feces for latent blood) is shown. To prevent the development of NSAIDs, gastropathy is recommended to be combined with PGE( misoprostol) preparations. Precautions are prescribed in childhood( up to 12 years), patients with severe impairment of liver and kidney function( regular monitoring of bilirubin, transaminase, creatinine, concentration of kidneys), arterial hypertension and chronic heart failure( daily control of diuresis, body weight, AD).If visual impairment occurs, reduce the dose or cancel the drug. It is not recommended to drink alcoholic beverages during the treatment period.
Other medications and medicines used together and / or in place of "Ibuprofen( Ibuprofen)" in the treatment and / or prevention of the following diseases. ..
According to the latest data, obesity is most likely to predispose to gout caused by excessive consumption of fatty foods of animal origin. At risk, lovers of sausages, wursts, bacon and hamburgers. It is the excess of proteins that leads to the excess of uric acid, and the extra weight creates an increased strain on the joints and, thereby, accelerates the development of the inflammatory process.
American scientists have also established a direct link between deficiency of calcium and ascorbic acid and the development of gout. With age, these important substances for the body begin to be missed even by those people who lead a healthy lifestyle and do not complain about excess weight. Therefore after forty years it is necessary to annually be examined and take multivitamins prescribed by the doctor.
Recently, a new drug, suppressing the synthesis of uric acid - Benzobromarone, has been developed. Now there are active clinical trials of this drug, and in some Western countries it has already been allowed and put on stream. But before the novelty rests on the domestic pharmaceutical market, it is likely that a lot of time will pass.
It is also known about experimental development of new non-hormonal anti-inflammatory drugs that directly affect the protein interleukin, which provokes gouty inflammation of the joints and tissues. But the exact timing of the appearance of these drugs in a free sale is difficult to call.
Allopurinol: Pros and Cons
The most popular drug for treating gout, Allopurinol, is increasingly being sharply criticized by modern doctors, as a large number of side effects and complications in its regular application raises questions about the usefulness of such therapy. According to statistics, an average of one in two hundred and sixty patients with gout Allopurinol provokes sudden death as a result of renal coma or cardiac arrest.
Nevertheless, the largest international study of Allopurinol, the results of which have recently been published in the scientific journal Annals of the eumatic Diseases, proves the high effectiveness of the drug, moreover - the ability to prevent the onset of death. This study certainly does not disprove the presence of side effects and high risk for the kidneys, and does not eliminate the need for new development. But we must admit that Allopurinol is still a first-line drug in the treatment of gout, at least because of good knowledge, reliability and affordable price.
Scientists tracked the fate of 5,927 patients who regularly took Allopurinol and the same number of patients treated with gout with other drugs that reduce uric acid levels. It turned out that the mortality in the first control group was 19% lower than in the second, and such results persist throughout the life of patients. That is, Allopurinol is still the most effective and safe drug, both for the treatment of acute, first-diagnosed gout, and for maintaining normal health in elderly patients with chronic disease.
Author of the article: PhD of medical sciences Volkov Dmitry Sergeevich, surgeon
Ibuprofen - instruction on the application, description, pharmacological action, indications for use, dosage and method of use, contraindications, side effects.
ibuprofen for gout what contraindications
"Blood often spoils". .. Yes, and with gout it "that the dead poultice". ..
With gout, only allopurinol will help you. The husband of 10 years was poisoned with ibuprofen, he only anesthetizes for a while, until he entered the hospital with a kidney stone. And all this from the purines in the blood. Now he has been drinking for more than six months allopurinol and everything is ok. And then I could not walk at all, turned into an invalid.