Strokes from gout are the best

Pricks 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-containing 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 needed by most people who suffer 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.

artrozmed.ru

Drugs for gout: what medications help cure arthritic arthritis

Gout is a disease in which deposits of uric acid salts are deposited in various tissues, including in the joints of the legs( most often 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.

Article list:

List of drugs helping to relieve an attack of the disease
Medications for treatment of an outbreak of arthritis
Folk remedies
Diet is your main assistant + video

If the gout is diagnosed 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 prescribe the appropriate 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 groups of medicines for the treatment of 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: drugs for arresting gout arthritis attack and drugs fortreatment of this disease outside seizures - in a relatively quiet period.

Medications to help 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 stops;
  • will not have 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, 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 for the treatment of 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, 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 probability 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 cancel therapy should only be taken 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 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!

Diet

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 urate inside our body( products with a high content of purine bases).

Meat, especially lamb and veal, and 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.

In fact, it is already only the observance of a diet with this disease can help in time to forget about this disease over time, so it is 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

What medicines will help to cure the gout

The joint is destroyed due to the deposition of uric acid salts

Gout is a joint disease, which is described by the scientists of antiquity. To combat it, use both long-known medicines and new drugs. Treatment of gout is usually done in two stages.

  1. First, eliminate pain, then relieve swelling. In this case, redness occurs from the sites damaged by the disease. Thus, the inflammatory process during an attack is removed. Treatment is carried out until the symptoms disappear.
  2. The next step is to use a cure for gout, which helps reduce the level of uric acid in the blood and reduces the frequency of seizures. For the disease to recede, the drug should be taken within a few days or weeks after another exacerbation of the disease.

The length of the course depends on the level of uric acid in the blood. In some cases, the medicine for gout will have to be taken for several years.


Features of therapy for gout

For the treatment of gout, a combined method of using medications is used. With a short-term therapeutic course, the administration of drugs that relieve pain and inflammation with a severe attack of the disease is prescribed. For these purposes, the patient is prescribed non-steroid drugs, and not aspirin, which can lead to an aggravation of the disease. During this period, colchicine is used, which can be recommended for long-term therapy.

The use of corticosteroids, which are sometimes injected directly into the affected joint, is indicated. This is necessary when other drugs do not work on the patient or are contraindicated to him. Many medications for gout can not be used if the patient suffers from chronic kidney failure, various gastrointestinal diseases with bleeding.

Long-term treatment uses drugs that lower the level of uric acid in the blood and remove it from the body through the kidneys. To reduce the production of this substance use allopurinol. To reduce the number of seizures will help such a drug as colchicine. It is also taken for preventive purposes to prevent an unwanted exacerbation of the disease.

If treatment is started in a timely manner, relief in case of an attack may occur within 24 hours. To do this, the doctor appoints a one-time intake of the maximum dose of one or more drugs. Subsequently, the amount of the drug taken is reduced.

All drugs that reduce the level of uric acid have many contraindications. Therefore, the doctor and the patient should be sure of the correctness of the diagnosis. The patient should not use aspirin to reduce pain, this can only intensify seizures.


Drugs for the treatment of the disease

There are many drugs around the world that are supposed to be used to combat gout. To eliminate the increase in the amount of uric acid in the blood, the use of the following medicines is recommended.

  • Losartan. It also uses to combat hypertension.
  • Fenofibrate. It affects some fats in the blood and helps to remove uric acid from the body.
  • Urtoxidase. Has the same effect as the above drug.
  • Febuksostat( Y-700).Affects the amount produced by the patient's body uric acid.

These drugs are used if the doctor for some reason can not prescribe the patient allopurinol. It is also worth studying the effect of three drugs, which are most often prescribed to patients suffering from gout.

The drug is good for removing uric acid from the blood

Fullflex is a remedy for gout and is used to eliminate the symptoms of myalgia, rheumatism, osteochondrosis, various types of arthritis. Has anti-inflammatory effect. Helps to eliminate pain in the attack of gout and removes uric acid from the body. It is prescribed to patients in the form of capsules or cream. Take it for a month for 1 tablet a day. The cream should be rubbed 2 times a day. Contraindicated in pregnancy and lactation.

Allopurinol as a cure for gout is used to control the increased amount of uric acid in the blood and in the presence of the complications caused by it. It is prescribed to patients in the form of tablets. Daily rate for gout 0.1-0.2 g. If the disease has an average severity, increase the dose to 3-4 tablets( 0.3-0.4 g).The decrease in the level of uric acid occurs after 1-2 days. The drug has no analgesic effect, but can reduce the number of gout attacks.

This remedy is contraindicated in cases of impaired liver function and during pregnancy. The main side effects: headache and dizziness, depression, general weakness, hematuria, nausea, diarrhea, vomiting. Perhaps the emergence of symptoms of hypertension or bradycardia, stomatitis. For individual intolerance, stop taking the medication immediately and consult a doctor who will choose another medication.

The medicine well anesthetizes and relieves the acute attack of the disease

Use a medicine called "colchicine" from gout. It has a very strong analgesic effect and is used to eliminate the symptoms of an acute attack. The drug is absolutely harmless to the body, since it has a vegetable origin. Produced in the form of tablets. Used during the next attack of the disease. The dose is 1 mg. After taking the first pill after 2 hours you need to drink the second - it eliminates joint pain, for example, with gout on the legs. The patient feels considerable relief 3 hours after the first dose, and it can last for 12 hours.

Colchicine is also used for disease prevention. Contraindications to its use: renal or pulmonary insufficiency, high sensitivity to the components of the drug. At pregnancy its use should be strictly supervised by the doctor. Side effects of colchicine: nausea, vomiting, the development of diarrhea, burning on the skin or urticaria, the appearance of muscle dystrophy. In men, a reduction in the number of spermatozoa is possible. If such events occur, you must stop using the drug.

The use of any medication prior to consultation with a physician is strictly prohibited. Only a specialist can make an accurate diagnosis and pick up medications taking into account the course of the disease and the individual characteristics of the patient's body.

MoiSustav.ru

If several joints are involved, non-steroid antibiotics are prescribed.

If the disease has gone far, the doctor may prescribe stronger remedies that reduce edema and suppress the synthesis of urea:

  • Glucocorticoid,
  • Colchicine.

Acute attacks of gout are removed by injection directly into the joint. The injection is done once, but in some cases it is necessary to repeat it.

If a disease associated with metabolic disorders( for example, diabetes) is identified, the doctor determines the treatment regimen for these diseases.

Control of excess uric acid

To limit the concentration in the body of uric acid are prescribed:

  • Aspirin in small doses to suppress the secretion of uric acid.
  • Butadione has a moderate effect, side effects are possible.
  • Anturan is the most effective drug today. It significantly reduces the presence of uric acid in the blood. A full normalization is possible within 2-3 weeks.
  • Ketazone in parallel has an anti-inflammatory and analgesic effect.
  • BENEMID is widely recognized as a very effective remedy. Can be used for a long time constantly. Breaks are prescribed up to 5 months in the case of long-term therapeutic effect.
  • Atofan is able to relieve an acute attack. But it is used very carefully because of side effects.
  • Urodane increases the solubility of urine formations.

Physiotherapy methods

A modern way of treating leg gout involves electromagnetic exposure or electrophoresis .With the help of electrical microcurrents, the salts formed undergo destruction, and uric acid is eliminated from the body. The most modern method of purifying blood is the use of a special apparatus called "Plasmophoresogemosorption".

Another progressive method of treating gout and arresting seizures is the cryoapheresis of .It is based on the use of low temperatures, affecting the blood and its constituent elements. This method:

  • retains and returns to the bloodstream cellular elements and useful substances in the maximum amount,
  • simultaneously removes uric acid and other components of the final exchange chain from the blood plasma to be removed from the body.

As an auxiliary method is treatment in a sanatorium and in a resort. In these places, there are all possibilities for a full range of physiotherapy procedures, including massage and physiotherapy.

If the course of the disease becomes particularly severe, resort to surgical removal of the outgrowths of the diseased joint.

Treatment with folk remedies

Decoctions and infusions

To remove excess urea from the body, folk medicine advises drinking decoctions and infusions, for example:

  • Infusion of cranberry leaves. A glass of boiling water pours 20 g of leaves. Insists half an hour. Drink during the day several times a tablespoon.
  • Juice of dioecious nettle take three times a day for 1 tsp.
  • Decoction of birch leaves. For two glasses of boiling water, two tablespoons of leaves.10 minutes to boil and insist for half an hour. After filtering, drink a quarter cup while eating.
  • Decoction of garlic and lemon. Very effective. Through the meat grinder, skip four lemons, chop three cloves of garlic. Pour the mixture with boiling water( 7 glasses) and insist 24 hours in a dark place. Take in the morning before meals for 3 tablespoons.l.

Baths and compresses

A good result is obtained when treating gout with the help of herbal baths. They can be prepared from:

  • of sage leaves,
  • of oat straw.

It is useful to soar your feet in a hot solution with laundry soap( rub half a piece) and salt( half-packs).

A simple and effective compress is prepared from 250 g of salt, which should be boiled in 100 g of water until the water evaporates. Then the medical vaseline( 200 g) is squeezed into the salt, and everything is mixed. Warm the compress on your aching legs and hold for the night.

A good tool for treating painful cones on the toes is a compress made from chemist's medicine bile. After 15 procedures, the pain passes. And as a result of 40-45 procedures, the lump resolves.

More complex composition of the compress of medical bile( 1 bottle) involves the addition of camphor alcohol( 160 g), red hot pepper( 1 tbsp.).The composition in the bank should stand for a week in a dark cool place.

Stand-alone actions

Short-term measures

Sometimes the pain is removed by applying ice to the affected joint. In other cases, dry heat is more effective( for example, a blanket, a heating pad).But this means for a short while removes manifestations of the disease.

The role of the correction of nutrition

A good result in the treatment of gout is compliance with the diet. With it, you can greatly reduce the level of urea in the body. We should not forget about unloading days.

Drinking fluid

You need to drink up to three liters of liquid per day:

LechimSustavy.ru

How can I reduce the pain with a gout attack? ??

Zoya Denisova

I do not know if it will help you. ..Movalis in pricks. And even stronger Ketonal in ampoules.

anton antonov

For gout it is necessary to increase the level of the wetted acid in the blood. It occurs either with an increase in the disintegration of purine bases, or because the kidneys do not work to remove uric acid. There can be both these reasons. An increase in the level of uric acid contributes to the accumulation and deposition of it in various tissues, especially in the cartilage of joints, salts of uric acid( urates) in the form of microcrystals. The periodic entry of crystals into the synovial cavity of the joints leads to the development of an acute inflammatory reaction. Uric acid and its salts are deposited in the urinary tract in the form of stones.
The disease develops almost exclusively in middle-aged men. Usually arthritis of the joints of the lower extremities with frequent involvement of 1 toe of foot, ankle and knee joints are observed. Less common arthritis of small joints of the hands and elbows. Gouty arthritis has characteristic features: it often develops at night, the intensity of pain grows very quickly and within a few hours reaches a maximum. The pain is usually very severe, movements in the joint become impossible, redness of the skin and an increase in the temperature of the tissues over the joint are observed. Body temperature may increase. Independently or under the influence of treatment, arthritis subsides in a few days, leaving no residual changes in most cases. The factors that provoke the onset of an attack of gouty arthritis include: excessive consumption of foods rich in purine bases, mainly meat, alcohol, surgery, trauma, and taking diuretics.15-20% of patients with gout develop urolithiasis( an attack of renal colic can sometimes be the first sign of gout).
Order this set of drugs at a discount
Universal system of complex treatment of gout with the help of dietary supplements Tianshi
The first stage - fighting inflammation and removing uric acid from the body by the kidneys.
1. Antilipid tea: in the morning an hour before meals pour 500 ml of boiling water 1 packet of tea and insist 15 minutes, drink in small sips during the first half of the day. Re-brew the same packet of tea and drink in the afternoon.
2. Cordyceps: 2 capsules in the morning 1-1,5 hours after meals, drink 250 ml of tea for 7 days, then 3 capsules - 10 days and 14 days for 4 capsules.
3. Chitosan: 2 capsules in the evening for 30 minutes.before meals, drink at least 250 ml of tea for 7 days, then 3 capsules - 10 days and 14 days for 4 capsules. Children from 12 years of age receive a dose of half.
4. San Gao: take 2 capsules 2 times a day before meals, drink tea. The course dose is 1 month.
The second stage - restoration of microcirculation, correction of metabolism in bone and cartilaginous tissue.
5. Biocalcium: 1/2 bags of powder diluted in 250 ml of briar broth( 20 berries insist in a thermos for 12 hours in 1 liter of water) take in the morning for 30 minutes.before breakfast, drink in small sips.
6. Spirulina: 4 tablets 30 minutes before dinner, drink with rose hip.
7. Biozinc: 2 capsules in the evening 1.5 hours after dinner, drink 250 ml of water.
The course dose is 1 month.
The third stage is the purification of blood vessels, improvement of metabolic processes.
8. Antilipid tea: in the morning an hour before meals pour 500 ml of boiling water 1 packet of tea and insist 15 minutes, drink in small sips during the day.
9. Holikan: 2 capsules in the morning 30 minutes before breakfast, drink tea.
10. Eel Fat: Take 2 capsules 2 times a day before meals, drink tea.
11. Spirulina: 4 tablets 30 minutes before dinner, drink with rose hip( continuation of the second stage).The course dose is 1 month.
The duration of the complex treatment system is 3 months. During the year, no less than 2 courses are conducted.
The fourth stage is the further implementation of preventive measures.
8. Bioenergetic health-improving mattress of tianshi: it is possible to apply all year round.
9. Chitosan: minimum course 2 times a year

Natalina

Muzu nado pit ALLOPURINOL po 2 tabletki utrom i vecherom( eto dlya ponizeniya mochevoi kisloti), a dlya obezbolivauschego effekta nado prinimat tabletki NAIZ,

Valery Valeriev

drink allopurinol or analogues right nowand outside seizures, prophylactically courses..for now. . - injections. . aflutop, lornoxicam, xefokam, can their anti-inflammatory and less analgesic effect strengthen ketene( to strengthen the analgesic effect)

VALERI

Tablets "ibuprofen", self use-help

Juliet

Ointment INDOVAZIN, compress on the diseased site. My husband helps.

Dr. Sasha

actually needs to be treated comprehensively.
but with severe pain something obezbalivayuschee.and the selection is usually
individual and experienced,
try dimeksid( application)
but still many help leeches very well.
is bought in a pharmacy( !!!) is planted on a sore spot.

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