Joint pain caused by gout often makes people miserable. However, many people do not go to the hospital for further examination and treatment in time after suffering from pain [after recovering the scar and forgetting the pain].
Many people think that there are only analgesic drugs for gout treatment, but besides analgesic, the more important treatment for gout is uric acid reduction in remission period.
Many gout drugs have been introduced before. Today, let’s review them in general.
Gout treatment drugs include both painkillers for acute attacks and uric acid lowering drugs for remission.
Drugs to control acute attacks
1. Non-steroidal anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs are widely used in clinical practice and have good effects, but they cannot be used in large quantities for a long time.
Traditional non-steroidal anti-inflammatory drugs (such as indomethacin, ibuprofen, etc.) have many side effects and may cause severe gastrointestinal hemorrhage. Therefore, it is recommended to take them after meals. If symptoms of stomach discomfort occur, some stomach-protecting drugs can be added at the same time.
Celecoxib and etcoxib are new non-steroidal anti-inflammatory drugs commonly used, with good curative effect and few side effects, but they are not suitable for patients with cardiovascular diseases.
Colchicine is the most familiar stranger to all gout patients. Many patients are afraid of the side effects of colchicine and refuse to use it.
Nowadays, the use of colchicine is no longer like the previous large-dose oral administration, but is changed to a small dose, which greatly reduces the side effects and has the same curative effect.
In addition, colchicine is now mostly used for preventive use during gout remission.
It is believed that many gout patients will have gout attacks in the process of lowering uric acid. This is not that lowering uric acid has no effect, but gout attacks caused by fluctuation of uric acid level in the body, which can be prevented by using colchicine in small doses at the same time.
Only when neither of the above two drugs can be used or the drug effect is not good will doctors consider choosing hormones. The use of hormones must be carried out under the guidance of doctors in regular hospitals.
Uric acid lowering drugs
Uric acid-lowering drugs are divided into two categories:
1. Inhibition of uric acid synthesis
Including allopurinol and a new xanthine oxidase inhibitor (febustat).
2. Promote uric acid excretion
It mainly includes probenecid, benzbromarone and sulfopyrazone.
The above two kinds of drugs have different mechanisms of action and have no absolute advantages and disadvantages. It is suggested that clinicians can choose the most suitable drugs according to the comprehensive situation of individuals.
It should be noted that for patients with kidney stones, it is not suitable to use drugs to promote uric acid excretion, because it will increase the burden on the kidney.
Drugs for alkalizing urine
It is mainly sodium bicarbonate or sodium potassium hydrogen citrate. Sodium bicarbonate is what we usually call baking soda.
The higher the urine pH value (i.e. The more alkaline) may increase the risk of calcium-related stones.
- The pH value of urine is below 6.0: alkalization of urine is required; The pH value of urine is between 6.2 and 6.9: it is conducive to the dissolution of urate crystals and their excretion from urine; Urine pH > 7.0: Calcium oxalate and other stones are easy to form.
Therefore, when taking such drugs, the pH value of urine must be regularly reviewed to adjust the medication and reduce the risk of urinary calculi.
Each drug has corresponding indications and contraindications, and there is no specific drug for gout treatment. Must go to a regular hospital specialist, by professional doctors according to the comprehensive situation to judge.
Sometimes, if one drug therapy cannot control the blood uric acid to the standard, doctors may consider combining several drugs. Gout patients must pay attention to the possible side effects during taking the medicine.