Treatment of Uric Acid Gout

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Uric acid gout is a joint disorder caused by disturbances in purine metabolism that result in disruption of the balance between the syntheses of uric acid excretion through the kidneys. This happens in foot. In patients with gout is often found that the levels of uric acid in the blood is too high (hyperuricaemia). Interference that may occur with high uric acid levels includes joint pain (arthritis), kidney stones due to uric acid stone formation (nephrolithiasis) and renal impairment (nephropathy).


Treatment Options and Medicines


In order to overcome the uric acid gout, we need such a therapy. The goal of the therapy is to stop acute gout attack, prevent recurrence of gout attack, and prevent complications associated with increased deposition of urine crystals in tissues chronically. In addition, patients should be reminded to reduce foods that contain purines (meat, offal, etc.). To overcome the attacks of gout arthritis, NSAID medications and colchicine are generally quite effective.  The main problem is the use of medications is gastrointestinal disturbance. Colchicine is an option in case of contraindications to NSAIDs. To avoid interference GIT, intravenous administration can be done. Colchicine is contraindicated for patients with leukopenia, severe renal impairment (keratinize clearance <10 mL / min), or any combination of kidney and liver disorders.


For patients who cannot tolerate colchicine and NSAIDs, we can use COX-2 selective inhibitors such as celecoxib, rofecoxib or valdecoxib. As a final choice of treatment if patients are resistant to the above things, the use of corticosteroids can be done. To prevent and cope with nephrolithiasis (kidney stones), it can be done with hydration (drinking heavily) for urine volume reached 2-3 L / day, investigation of urine, and avoid foods containing purines. Investigation of urine can be done by administering a solution of sodium bicarbonate. If the patient contraindicates to the Na salt, replacement with potassium citrate can be done. Also, it can be acetazolamide, a carbonic anhydrase inhibitor, for alkalinization of urine. The main therapy for recurrent uric acid gout is allopurinol.

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These drugs are effective in reducing uric acid levels in serum and urine, thus preventing the formation of uric acid crystals. After the first acute attack or the first spending of kidney stones, necessary prophylactic therapy for prevention of recurrence attack. Prophylactic therapy can be done with the colchicin or allopurinol. Such therapies for arthritis disorders are common, namely rheumatoid arthritis, osteoarthritis, and gout.


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