Injections and treatment for gout
Gout is often referred to as "the disease of kings".Such a term entrenched itself for ailment because of the habits of rich and influential people who have a special passion for wine and fine cuisine. In fact, pathology can hit any person. Risk factors for the development of the disease are: arterial hypertension, hyperlipidemia, as well as the consumption of red meat, some varieties of fish, coffee, tea, alcoholic beverages, especially beer. Foam drink in its composition contains a large amount of guazinozin - a substance that is the progenitor of uric acid.
Fortunately, at the present time, to eliminate gout attacks, a special diet is developed, a huge number of drugs have been invented, which reduce to almost minimum the painful attacks characteristic of gout. The most effective medicines for gout are injections, which are mostly made intravenously or intramuscularly.
Treatment of acute attacks
One of the effective methods for treating active outbreaks with gout is the appointment of colchicine. This medication can be effective if prescribed at the onset of gout attacks. Nevertheless, the drug can cause a number of side effects: nausea, vomiting, diarrhea and other similar symptoms. Side effects are less common with the introduction of the drug intravenously. However, since the drug has a very high activity, it can exert a strong irritant effect on the skin and veins. To minimize the effects of the drug, intravenous injection of the solution is carried out at the minimum rate of drug administration. The drug is always administered under the supervision of a doctor. The administration of the drug may take several minutes, and this is considered the norm.
If colchicine does not give a significant improvement in well-being in patients and causes severe side effects during gout, the physician may prescribe treatment with non-steroidal analgesics( NSAIDs).This group of drugs includes aspirin, as a medicine that reduces inflammation and relieves pain. Indomethacin( Indocin) and Naproxen( Naprosyn), which are administered intravenously in the most acute attacks of gout.
In medical practice today there is no statistics of which of the drugs is the most effective for gout. High doses of short-acting NSAIDs give the fastest results in relieving pain symptoms. However, these drugs can cause side effects: indigestion, rash on the skin or diarrhea. If drugs are prescribed in the short term, they are most likely to be well tolerated by most patients.
But some people can not use NSAIDs due to chronic diseases, such as stomach diseases or due to various kidney dysfunction. In such patients, doctors prescribe injections of corticosteroids, such as prednisone and triamcinolone. The injections are made into the muscle, and are considered very effective treatment for gout. If during the exacerbation of the disease the patient suffers 1-2 joints, the doctor can prescribe the use of corticosteroids directly on the affected joints.
In particularly difficult cases of the disease, the doctor may prescribe an Anakinra( Kinnereta) shot. Although the drug is not approved for use in rheumatoid arthritis, it is actively prescribed by doctors to treat gout and can quickly alleviate the symptoms of pathology in some patients.
Treatment for the removal of excess uric acid
Patients who, due to abnormally high blood levels of uric acid, often have gout attacks, need injections that lower the level of acid in the blood. These drugs do not eliminate pain, so they should be prescribed after the acute course of the disease.
Most often, allopurinol( Lopurin, Zyloprim) is prescribed as a sick gout. It blocks the production of uric acid. Recently, on the shelves of pharmacies appeared analogue medications - Febuxostat( Uloric).Equally effective is the drug Probenecid( Benemid), which helps the kidneys remove uric acid.
An effective drug is Pegloticase Krystexxa, which is injected into the patient's body. It changes the composition of uric acid and neutralizes its harmful effects. The drug is specifically designed for patients who do not respond to other treatments or who can not tolerate their side effects. Today, a huge number of new drugs designed to reduce the level of uric acid in the blood and to treat gouty inflammation are being developed.
If a patient takes medications that reduce the concentration of uric acid in the blood, the doctor should regularly increase their doses and closely monitor the patient's well-being. As soon as the level of uric acid drops below 6 mg per 1 kg of body weight( to normal values), dissolution of crystalline deposits on the joints begins, and the patients' well-being significantly improves. For many patients, the fight against the disease is prolonged for the long term and is aimed at preventing gout attacks.
Those drugs that work well for one person are often ineffective for another. Therefore, it follows the decision about when to start treatment and which drugs are more suitable for each individual case. For all patients, they are different and can only be prescribed by a doctor. The choice of treatment depends on the function of the kidneys, existing health problems, personal preferences and other factors.
What you eat can increase the level of uric acid. Therefore, patients who have gout should limit themselves to eating high in fructose and soda. In addition, exclude from the diet alcohol, especially beer. Limit the use of foods that are rich in purine and which, falling into the blood, break down into uric acid and other not very useful ingredients. High content of purine is present in meat, in some types of seafood. Purina is plentiful in some vegetables. Low-fat dairy products can help reduce uric acid levels.
Almost in all cases, it is possible to successfully treat gout and achieve a gradual cessation of exacerbations. Treatment can also reduce the number and size of gouty tofus - the focus of abnormal thickening of the subcutaneous tissue.
What should I remember when diagnosing a disease?
Arthritis attacks, which from time to time come and go, are a sign of gout. The search for characteristic crystals in the joint fluid allows medical workers to correctly diagnose gout.
In medicine, there are 2 types of fighting gout. First, to control acute attacks of joint pain, there are NSAIDs, colchicine and corticosteroids. Secondly, after eliminating the acute course of the disease, injections are used that can reduce the level of uric acid for a fairly long time.
People with chronic gout usually require lifelong treatment and injections that lower the level of uric acid.
Changes in lifestyle, such as weight control, limiting alcohol, eating red meat, fish and foods rich in purine, can curb the disease and help control gout.
Injections in the treatment of gout
Injections for gout are prescribed not only because the patient's condition does not improve the pill. Gout refers to the category of ailments that are accompanied or result from abnormalities in the functioning of the gastrointestinal tract. The human body can tolerate the tablet preparation well, but its absorption by the stomach can lead to a number of negative side effects. In such cases, the patient is given injections.
Causes of the disease
Treatment of gout is a complex process. Its effectiveness depends not only on tablets and injections, but also on proper nutrition of the patient, compliance with optimal sleep and wakefulness, balanced physical activity. The first task of using drugs for gout is to eliminate pain symptoms. Mandatory treatment for the disease uses drugs that prevent repeated attacks of gout, reducing their duration. A special place in therapy is taken by injections and tablets, which prevent and reduce the severity of the numerous complications that the disease carries with it.
The selection of drug therapy necessarily takes into account the factors that provoked a person's onset and development of gout. To combat the excessive content of salts of uric acid, which is observed with gout, it is necessary to carry out a combined effect not only on the joints, but also on the metabolic processes taking place in the body. In official and folk medicine, activated charcoal is widely used against this ailment, it is a simple and reliable means of purifying the body. The drug is taken externally and internally. Activated carbon removes toxins, toxins, stimulates the work of the gastrointestinal tract and pancreas.
More about coal and vitamins
The activated carbon preparation itself is not an anesthetic, but its use can significantly reduce pain symptoms due to the fact that it:
- absorbs and removes uric acid salts;
- neutralizes toxins;
- reduces cholesterol;
- stimulates the functioning of the kidneys, the functioning of which is often disturbed by gout.
To prepare at home the simplest preparation for external use, it is enough to mix coal and linseed oil.
If a person has an exacerbation of a pain attack to alleviate the condition of the patient, the activated charcoal is mixed with water and taken twice a day one hour before a meal. This remedy helps to stop the inflammatory process in the joints, since coal fights the original cause, sucking in the inflammatory salts of uric acid. When taking this medication, vitamins are not contraindicated, the complex of which must be selected strictly in the individual order. Vitamin E, for example, is necessary for most people suffering from this ailment, and vitamin A has the opposite effect and is capable of causing a gout attack. In the fight against the disease, vitamins C, B12, folic and pantothenic acids are actively used, which are also combined with activated carbon.
Flaxseed oil, flax seeds and activated charcoal are some of the most popular cure for gout. In linseed oil contains biologically active substances, the effect of which activated charcoal reinforces. Such means are applied externally and internally. Their preparation at home is also not difficult. Coal is ground and mixed with flax seeds or oil. If the pasty mass is used as an anesthetic and inflammatory ointment, it is applied at night to the area of the body where the joints are affected, cover the area with a food film and warm it with a woolen cloth.
How to get rid of inflammation and pain
Voltaren has similar properties, which relieves pain symptoms and reduces inflammation. The drug belongs to the category of nonsteroidal agents. Voltaren is produced in various forms, including as an ointment, plaster, tablets. The latter are characterized by prolonged action. If the patient's condition worsens, Voltaren's injections, which are administered intramuscularly, can be prescribed. As a rule, the drug is used only during gout exacerbation, when Voltaren injections create a barrier for further aggravation of the attack. As soon as pain symptoms decrease, doctors replace injections with tableted preparations. There is a strict rule of not applying injections: their course lasts on average no more than 2 days, because Voltaren has a number of side effects, among which:
- severe allergic reactions;
- disruption of the gastrointestinal tract and liver.
Voltaren is able to cause visual and hearing impairments, it reduces immunity and increases the number of white blood cells in the blood. Therefore Voltaren is recommended to be used only in conditions of inpatient treatment.
Anti-inflammatory, analgesic, restoring
No less popular means against gout is Alflutop. It is also administered intramuscularly, but it has a milder and more gentle effect on the body. Alflutope belongs to the category of chondroprotectors, it has analgesic, anti-inflammatory effect and normalizes metabolism in the joints. Assign Alflutop, when it is necessary to prevent or stop the destruction of articular tissues. The course of treatment lasts up to 20 days. Obtain Alflutop from the cartilaginous tissues of marine fish, so it has a relatively small list of contraindications and side effects. However, Alflutop is not prescribed for pregnant and lactating women.
The use of Movalis as a remedy for gout is due to the fact that the drug effectively relieves pain symptoms. Movalis belongs to the category of non-steroidal anti-inflammatory drugs, it is used for short-term symptomatic therapy. Movalis is not allowed to be administered intravenously, its overdose is extremely dangerous, because it can cause acute kidney failure, pressure jumps, respiratory arrest, gastrointestinal bleeding. It is not possible to administer Movalis concomitantly with other drugs, it is applied strictly dosage for several days. In severe forms of liver failure, Movalis is contraindicated.
Gout is a disease that affects joints due to the deposition of uric acid salts. The disease has a relative prevalence - only three people out of a thousand are likely to get it.
It develops usually after 40 years, and affects both men and women with the same frequency. The joints that are most susceptible to injury are located on the toes.
There are several factors that increase the risk of developing gout:
- hereditary factor;
- unbalanced power supply.
Thus, it can be concluded that gout develops in those who have a disturbed balance of substances in the body.
To understand how to treat gout with medicines, you need to know its symptoms.Symptoms for gout
The disease manifests itself suddenly, and is accompanied by severe pain. The patient feels heat in the joint area, and this happens, as a rule, at night. The sensitivity of the joint at this moment is so high that even under the weight of a light sheet, severe pain can develop.
Subsequent seizures have a slightly different course: before a sensation of heat and severe pain occurs, the patient feels a tingling sensation in the joint area.
In the absence of treatment, seizures occur more often, and the disease affects new joints. Often, a neglected process causes the pathology of the kidneys and urinary tract.
Before choosing a medicine to treat gout, it is worthwhile to understand what processes occur in the body in connection with this disease:
- The level of uric acid in the blood increases.
- Accumulation of uric acid compounds occurs in the body.
- Urine compounds are deposited in tissues and organs.
- Develop gouty buds and granulomas around the joints.
It is impossible to get rid of gout completely, but slow down the development process and make life easier for the patient during seizures in the possibilities of modern medicine.
The best cures for gout
Drugs used for gout on the legs and other parts of the body are few - just a few groups of medicines.
Drugs used during attacks
So, the first cure for gout is Colchicine, which affects the exchange of uric acid. This is a direct-acting anti-gout medication based on a cesspool. It relieves pain and has analgesic effect, and also reduces the migration of leukocytes to the affected area, inhibits the formation of microcrystals of uric acid and prevents their deposition in tissues. Thus, the drug is directed not only to preventive - prospective treatment, but also situational, due to anti-inflammatory effect and anesthesia.
Medication can not be used for renal and hepatic insufficiency. If it is taken for a long time, then there is a threat of leukopenia and anemia.
The effect of the drug is observed in the first 12 hours after admission, provided that it is taken at the beginning of the attack. If it begins to be taken late, there will be no positive result from the treatment, or it will be less noticeable. The medication is effective in 90% of cases.
Among modern medicines for gout - NSAID means. In these cases, two series of medicines are widely used:
- pyrazolone - Reopyrin, Butadion, Phenylbutazone, Ketazol;
- indole - Indomethacin, Metindol.
These new medicines for gout during seizures are better tolerated than Colchicine, and also give a more pronounced therapeutic effect.
Voltaren is also often used to stop gout attacks. The first dosage is shock, is 200 mg per day, and then it is prescribed in a smaller amount - 150 mg per day.
All these medications are designed to treat seizures. For the treatment of chronic form the following drugs are used.
Gout remedies for long-term use of
For long-term use, a medicine for gout Allopurinol is suitable. It is aimed at reducing the level of uric acid in the blood plasma and is released in tablets of 0.1 and 0.3 g.
Treatment is started in small dosages to avoid exacerbation of the disease and to prevent an allergic reaction. Medication is not prescribed during attacks - before taking Allopurinol, it is necessary to achieve a stable, calm condition of the joint. In most cases, the drug is well tolerated.
In addition to Allopurinol, analogs can also be used for treatment:
Gout is an ancient disease described by Hippocrates. Pan's twig, a disease of kings and aristocrats. But behind these beautiful words are hidden periodic very painful attacks, accompanied by painful pains. After all, with gout affected joints and most often on legs, they are deposited crystals of uric acid - urate. As a result, the joints of the legs periodically become inflamed, swell and hurt. And without taking action, these attacks will increase. Treatment of gout on the legs is always performed in a complex and consists of several main tasks:
- rapid removal of an acute attack of gout;
- relapse prevention;
- therapy between the seizures.
To stop an acute attack or attack with gout, a colchicine drug is used. It effectively stops the attack, reducing the level of uric acid to normal, reducing pain and inflammation in the legs. In the first 12 hours there is relief.
The drug is injected slowly intravenously with saline, starting at 1 g. Maximum at a time you can enter 2gr. After the injection of 7 days, the remedy is not applied. If before this medicine was prescribed inside, it can not be stabbed.
Treat colchicine with caution in diseases of the liver and kidneys, in the elderly. For them, there are sparing schemes for taking the drug. It is not applied in renal and hepatic insufficiency, infringement of a glomerular filtration. Long-term treatment leads to a reduction in the number of red blood cells and white blood cells.
Acute attack can be treated with large doses of drugs from the NSAID or NSAID group. They are carried by the body of patients much easier. When there are side effects from one remedy, it is possible to replace it with another.
The most widely used will be voltaren. Assign it with gout on the leg intramuscularly up to two times per day. First day, add 200 mg, then 150 mg. The drug is well tolerated, very effective in prolonged forms.
The safest in the treatment of the occurrence of various complications are inhibitors of COX or cyclooxygenase( nimesulide, meloxicam).
If, for any reason, the listed drugs are not suitable, or there are contraindications( ulcers, kidney failure), you can cure an acute attack using glucocorticosteroids. Their introduction in the form of injections gives a quick and persistent therapeutic effect, although occasionally treatment can be complicated by short-lived hyperglycemia.
To prevent relapses and treat gout in the interictal period, two types of drugs are administered:
- drugs that increase uric acid release;
- drugs that reduce its synthesis.
Treatment with allopurinol reduces uric acid in the blood, prevents the formation of urate stones in the urinary tract. Initiate therapy with an initial dose of 50-100 mg and increase to 500 mg, depending on the severity of the disease.
Principles for the treatment of gout on legs with allopurinol:
- is not assigned for an attack;
- treatment starts with small doses.
No prescription for children, pregnant women, patients with impaired liver function, suffering from hemochromatosis. Has its own side effects.
The derivative of allopurinol, which inhibits the synthesis of uric acid, is thiopurinol. Patients with gout on their legs carry it easier than the previous one.
Another drug is probenecid or benemide. The usual daily dose is up to 2 mg. Sometimes the application can be complicated by digestive disorders, allergic reactions.
Sulfinpirazone or anthuran is taken after a meal and is recommended to be washed down with milk. Contraindications are gastric ulcer of the duodenum, severe kidney and liver pathology.
Benzobromarone or dezurik is taken with food only once and requires sufficient alkaline reaction( 2L) from the patient.
Hypuric, losartan, allomarone are all these remedies, also used for gout on the legs. Treatment is carried out under the supervision of a doctor, regular monitoring of the condition of patients with the help of tests.
Successful treatment of gout is possible only with joint efforts, both physician and patient.
An important part of this success is changing the diet and carefully adhering to a special diet. These measures can significantly improve the patient's condition, lengthen the period between attacks, prevent the deposition of salts in the joints of the legs.
With gout, foods with high purine content should be excluded, salt and fats should be limited, and the number of animal proteins should be reduced. Food should contain enough vitamins, taken in small fractions and in small portions( up to 6 times).Recommended water is an alkaline reaction, a regular intake of citrus, which promote the excretion of urate. The food should be steamed or boiled. Vegetables are useful raw, boiled and baked.
- bread products( minimum puff, sweet dough);
- boiled meat, low-fat poultry, fish up to 2 times a week;
- all dairy, excluding hot cheeses;
- vegetable and butter;
- any vegetables, restricting pickles and marinades;
- fruit fresh and past cooking;
- various drinks, such as juices, fruit drinks, broths of wild rose, mineral waters, weak tea.
Treatment with diets presupposes copious drinking, lack of hunger and availability of a list of products forbidden to the sick:
Treatment of gout at the time of acute
development Patient suffering from this disease should know that somepreparations from gout at the time of an acute attack can not be taken or treatment should be conducted only under the constant supervision of a doctor and control of laboratory blood indicators.
If the patient develops the first attack of gouty arthritis, then only anti-inflammatory drugs are prescribed for his cupping - use at this time of drugs that reduce the concentration of uric acid leads only to a sharp deterioration in the patient's condition. These drugs cause the uric acid to "move" in the peripheral tissues of the body, the concentration of this substance in the blood increases, and it can again be massively deposited in the joints, glomeruli and tubules of the kidneys.
If the patient has previously been diagnosed with a high uric acid content and prescribed gout treatment, the drugs should be taken at previously recommended dosages of .
Drugs for arresting an attack
If a patient develops gout - treatment with medicines helps relieve pain, reduce swelling and redness of tissues, restore normal mobility in the joint. To do this, prescribe:
- non-steroidal anti-inflammatory drugs - any gout tablets that include any of the drugs from this group( movalis, nimesulide, indomethacin, ibuprofen) can be used. The only drug that should be excluded is acetylsalicylic acid( aspirin) - it can cause the same changes as drugs that lower the level of uric acid in the tissues;
- colchicine is a chemotherapeutic agent capable of reducing the severity of gout exacerbation;
- glucocorticoids are drugs prescribed only when painkillers are ineffective for gout and colchicine.
In this disease it is important to start treatment with the administration of drugs inside or in the form of injections - ointment for treating gout in the acute period of the disease is ineffective. Ointment from gout can be prescribed only if the acute inflammation subsides against the backdrop of ongoing systemic therapy.
Preparations for the prevention of an attack and the normalization of metabolism
Preparations for gout in the interictal period should be prescribed by very long courses, under the control of laboratory indicators and against the background of compulsory compliance with the diet. In this case, prescribe:
- drugs prescribed to suppress the synthesis of uric acid in the body - in our country is allowed to use allopurinol;
- agents that enhance the excretion of uric acid with the kidneys;
- colchicine - the only drug used at any stage of the disease, but under constant medical supervision
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