Gout Medicine Information

 

Gout Medicine

Gout is a purine metabolism disorder resulting from an excess of uric acid in the blood (hyperuricaemia), due to either its overproduction or faulty elimination. Crystals of overproduction or faulty elimination. Crystals of monosodium urate begin to precipitate and get deposit in joints, skin, kidney and other tissues. Gouty arthritis usually involves a single joint (monoarticular), but may involve many joints (polyarticular) specially in the later course of the disease. Classically the great toe is involved, course of the disease. Classically the great toe is involved, characterized by pain (podalgia), swelling, tenderness, and other signs of inflammation.

Classification: three types of drugs are employed in the treatment of gout:
1. Drugs used in acute gout to terminate the inflammatory process and prevent its recurrence: Colchicines, phenylbutazone, oxyphenbutazone, naproxen, corticotrophin, corticosteroids.
2. Drugs used for long-term control of gout, acting by increasing the excretion of uric acid by the kidneys, i.e., uricosuric agents: Probenecid, suiphinpyrazine.
3. Drugs for prevention of urate synthesis in the body: Allopurinol.

Acute Gout: The acute attack of gout is due to the precipitation of monosodium urate crystals in the joint. These are irritant and an acute inflammatory response occurs which is exceedingly painful.

Colchicine 
Colchicine is an alkaloid derived from the corm and seeds of Colchicum autumnale, known for centuries for its medicinal qualities. It has no anti-inflammatory or analgesic activity, but is very effective in suppressing inflammation and pain in gouty joints when taken promptly in adequate amounts. It does not enhance renal excretion of uric acid or reduce its concentration in the blood.

Uricosuric Drugs

Probenecid 
The drug-induced movement of uric acid from deposits in tissues back into the blood may at first increase the number of acute attacks, for the prevention of which probenecid is initially combined with small amounts of colchicines. Probenecid is ineffective in acute gout.

Xanthine Oxidase Inhibitor

Allopurinol
In a search for an ideal antitumor drug, it was found that Allopurinol is a potent Xanthine Oxidase inhibitor. Chemically it is a hypoxanthine analogue.
Allopurinol is used for gout prophylaxis, and for long-term treatment of hyperuricaemia and its complications.