Disease or gout Gout is a disorder in uric acid and purine metabolism that lead to deposition of monosodium urate crystals in joints, fingers, toes and can cause inflammation of the kidneys.
Therapeutic target in gout is to maintain the levels of uric acid in the blood under 6mg/dL and reduce the pain caused by a buildup of uric acid. As for the therapeutic purpose of gout are:
A. Reduce inflammation and joint pain during acute attacks
2. Prevent replay attacks and the occurrence of serious complications (kidney stones)
3. Prevent severe joint abnormalities due to accumulation of urate crystals
4. Prevent the formation of stones in the urinary tract.
Therapeutic strategies in disease gout done in 2 ways, namely non-pharmacological therapy (without the use of drugs) and pharmacological therapy (using drugs).
a. Non-pharmacological therapy (without medication)
Non-pharmacological therapy (without medication) for people with gout can be done as follows:
A. Diabetes management
Low-fat diet by limiting foods high in purines and choose foods low in purines. The following classification of food based on the content of purines:
a. Class A: Foods that contain high purine (150-800 mg/100 g food) is the liver, kidney, brain, heart, lung, other organ meats, shrimp, mussels, clams, sardines, herring, meat extracts (shredded, beef jerky ), yeast (tape), alcohol and food in cans.
b. Group B: Foods that contain purines moderate (50-150 mg/100 g food) is a fish that does not include class A, beef, shellfish, dried beans, cauliflower, spinach, asparagus, beans, mushrooms, leaves cassava, papaya, kale.
c. Class C: Foods that contain purines lighter (0-50 mg/100 g food) are cheese, milk, eggs, other vegetables, fruits.
Diabetes management should be done when the uric acid levels exceed 7 mg / dl by not consuming food and class A limit themselves to mengkonsmsi food group B.
2. Increase the drinking water can help get rid of purines in the body.
3. Avoid alcoholic beverages.
4. Lose weight for the obese (overweight).
5. Plenty of rest and avoid working too hard.
b. Pharmacological therapy (using drugs)
Therapy for patients with gout are usually divided into 2 therapy in treatment of acute attacks and chronic hyperuricemia in the assault. Pharmacological therapy (with drugs) for patients with gout can be done in three stages, namely:
A. Cope with pain during acute attacks,
2. Reducing uric acid levels to prevent the accumulation of urate crystals.
3. Preventive therapy using the drug hipourisemik.
The medicines used for gout therapy are:
A. Anti-inflammatory Nonstreoid Drugs (NSAIDs)
NSAIDs are an effective first-choice therapy for patients with acute gout attacks. There are several types of NSAIDs, but not all have good efficacy and safety for the treatment of acute gout. Some NSAIDs are indicated to address the acute gouty arthritis with a rare incidence of side effects occur:
a. Naproxen
Naproxen is a propionic acid derivative NSAID is efficacious anti-inflammatory, analgesic, and antipyretic. Naproxen has been one of the first choice because of efficacy and side effects are rare events.
b. Diclofenac Sodium
Is the class of propionic acid derivative NSAID that has a way of working and the same side effects with naproxen.
c. Piroxicam
Is the class of NSAIDs that have anti-inflammatory activity, analgesic - antipyretic.
d. COX-2 selective NSAIDs
Is the class of NSAIDs that have upper gastrointestinal safety level is better than non-selective NSAIDs.
2. Colchicine
Colchicine effectively used for acute gout attacks. When compared with the first NSAID work (onset) is slower and more common side effects, so it is not recommended for long-term treatment of acute gout. Colchicine is used only during a critical time to prevent gout attacks.
Colchicine side effects that often occur are nausea and vomiting, diarrhea and abdominal pain that occurs in 80% of patients. The main complication of this therapy is dehydration.
3. Corticosteroids
Corticosteroids are often used to relieve symptoms of acute gout attacks and will control. Corticosteroids are extremely useful for patients who are contraindicated to the NSAID group. If goutnya monarticular, antra-articular administration of the most effective.
4. Uricosuric
This drug blocks the tubular reabsorption of filtered urate which thus reduces the number of metabolic muscle, prevents the formation of new lumps and bumps reduce the size of existing ones. Sulfinpirazon Uricosuris as probenecid and allopurinol can be given as a substitute, but probenecid is not indicated for acute gout. The formation of urate crystals in the urine can occur with urocisuric and it is important to ensure sufficient amount of urine that is 2000 ml or more to prevent pengendapat urate crystals in the urinary tract. When given in combination with colchicine, will reduce the frequency of recurrence of acute gout.
5. Allopurinol
Allopurinol is a xanthine oxidase inhibitor that works to reduce production of uric acid by xanthine oxidase inhibitory action of the enzyme that produces uric acid. These drugs are very beneficial for patients with renal failure or urate stones that can not be given urocisuric. Allopurinol also has a positive effect in fighting the "bad" cholesterol in the body. Thus, this drug is a better option for patients with hyperuricemia who also suffer from coronary artery blockage.
This medication is usually given once a day for the active metabolite of allopurinol long half-life. Initial dose of 100 mg given for 1 week; then increased if the uric acid levels are still high. Serum uric acid levels will be achieved with a daily dose of 200-300 mg. Often a combination of allopurinol with the uricosuric would be very helpful. Allopurinol is not recommended for the treatment of asymptomatic hyperuricemia and gout are active.
Allopurinol is used to prevent another attack of gout for long-term therapy and can not be used to relieve acute attacks in the attack. Common side effects of allopurinol is hypersensitivity or allergy, the symptoms that occur in the form of symptoms of redness on the skin. For patients who experience allergic reactions such are advised to immediately stop taking allopurinol as soon as possible.
Therapeutic target in gout is to maintain the levels of uric acid in the blood under 6mg/dL and reduce the pain caused by a buildup of uric acid. As for the therapeutic purpose of gout are:
A. Reduce inflammation and joint pain during acute attacks
2. Prevent replay attacks and the occurrence of serious complications (kidney stones)
3. Prevent severe joint abnormalities due to accumulation of urate crystals
4. Prevent the formation of stones in the urinary tract.
Therapeutic strategies in disease gout done in 2 ways, namely non-pharmacological therapy (without the use of drugs) and pharmacological therapy (using drugs).
a. Non-pharmacological therapy (without medication)
Non-pharmacological therapy (without medication) for people with gout can be done as follows:
A. Diabetes management
Low-fat diet by limiting foods high in purines and choose foods low in purines. The following classification of food based on the content of purines:
a. Class A: Foods that contain high purine (150-800 mg/100 g food) is the liver, kidney, brain, heart, lung, other organ meats, shrimp, mussels, clams, sardines, herring, meat extracts (shredded, beef jerky ), yeast (tape), alcohol and food in cans.
b. Group B: Foods that contain purines moderate (50-150 mg/100 g food) is a fish that does not include class A, beef, shellfish, dried beans, cauliflower, spinach, asparagus, beans, mushrooms, leaves cassava, papaya, kale.
c. Class C: Foods that contain purines lighter (0-50 mg/100 g food) are cheese, milk, eggs, other vegetables, fruits.
Diabetes management should be done when the uric acid levels exceed 7 mg / dl by not consuming food and class A limit themselves to mengkonsmsi food group B.
2. Increase the drinking water can help get rid of purines in the body.
3. Avoid alcoholic beverages.
4. Lose weight for the obese (overweight).
5. Plenty of rest and avoid working too hard.
b. Pharmacological therapy (using drugs)
Therapy for patients with gout are usually divided into 2 therapy in treatment of acute attacks and chronic hyperuricemia in the assault. Pharmacological therapy (with drugs) for patients with gout can be done in three stages, namely:
A. Cope with pain during acute attacks,
2. Reducing uric acid levels to prevent the accumulation of urate crystals.
3. Preventive therapy using the drug hipourisemik.
The medicines used for gout therapy are:
A. Anti-inflammatory Nonstreoid Drugs (NSAIDs)
NSAIDs are an effective first-choice therapy for patients with acute gout attacks. There are several types of NSAIDs, but not all have good efficacy and safety for the treatment of acute gout. Some NSAIDs are indicated to address the acute gouty arthritis with a rare incidence of side effects occur:
a. Naproxen
Naproxen is a propionic acid derivative NSAID is efficacious anti-inflammatory, analgesic, and antipyretic. Naproxen has been one of the first choice because of efficacy and side effects are rare events.
b. Diclofenac Sodium
Is the class of propionic acid derivative NSAID that has a way of working and the same side effects with naproxen.
c. Piroxicam
Is the class of NSAIDs that have anti-inflammatory activity, analgesic - antipyretic.
d. COX-2 selective NSAIDs
Is the class of NSAIDs that have upper gastrointestinal safety level is better than non-selective NSAIDs.
2. Colchicine
Colchicine effectively used for acute gout attacks. When compared with the first NSAID work (onset) is slower and more common side effects, so it is not recommended for long-term treatment of acute gout. Colchicine is used only during a critical time to prevent gout attacks.
Colchicine side effects that often occur are nausea and vomiting, diarrhea and abdominal pain that occurs in 80% of patients. The main complication of this therapy is dehydration.
3. Corticosteroids
Corticosteroids are often used to relieve symptoms of acute gout attacks and will control. Corticosteroids are extremely useful for patients who are contraindicated to the NSAID group. If goutnya monarticular, antra-articular administration of the most effective.
4. Uricosuric
This drug blocks the tubular reabsorption of filtered urate which thus reduces the number of metabolic muscle, prevents the formation of new lumps and bumps reduce the size of existing ones. Sulfinpirazon Uricosuris as probenecid and allopurinol can be given as a substitute, but probenecid is not indicated for acute gout. The formation of urate crystals in the urine can occur with urocisuric and it is important to ensure sufficient amount of urine that is 2000 ml or more to prevent pengendapat urate crystals in the urinary tract. When given in combination with colchicine, will reduce the frequency of recurrence of acute gout.
5. Allopurinol
Allopurinol is a xanthine oxidase inhibitor that works to reduce production of uric acid by xanthine oxidase inhibitory action of the enzyme that produces uric acid. These drugs are very beneficial for patients with renal failure or urate stones that can not be given urocisuric. Allopurinol also has a positive effect in fighting the "bad" cholesterol in the body. Thus, this drug is a better option for patients with hyperuricemia who also suffer from coronary artery blockage.
This medication is usually given once a day for the active metabolite of allopurinol long half-life. Initial dose of 100 mg given for 1 week; then increased if the uric acid levels are still high. Serum uric acid levels will be achieved with a daily dose of 200-300 mg. Often a combination of allopurinol with the uricosuric would be very helpful. Allopurinol is not recommended for the treatment of asymptomatic hyperuricemia and gout are active.
Allopurinol is used to prevent another attack of gout for long-term therapy and can not be used to relieve acute attacks in the attack. Common side effects of allopurinol is hypersensitivity or allergy, the symptoms that occur in the form of symptoms of redness on the skin. For patients who experience allergic reactions such are advised to immediately stop taking allopurinol as soon as possible.
Hy.
BalasHapusDo you write this article with your opinion? or copy from other sites?
Uric acid is a chemical created when the body breaks down substances called purines. It is found in the foods and drinks. One of the reasons why we got that disease called gout. But, we have more prevention techniques that can help us to relieve gouty arthritis. Treatment includes medicines and steps you can take home to prevent gouty arthritis attacks. There are other suppositories for treating gout. Try to visit EverHealthy pain alleviator review. Hope it will help.
BalasHapusmedications that lower the level of uric acid in the bloodstream, such as allopurinol (Zyloprim, Aloprim), can also initially cause a flare of gout. Basically anything that raises or lowers the your acid levels can cause a gout flare by causing uric acid crystals to deposit in a joint. What is Gout
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