Gout is one type of arthritis. Gout occurs due to accumulation in the tissues, which, with the normal functioning of the kidneys, must be excreted from the body along with urine. The symptoms of gout are intense pain in the joints, their redness and sensitivity to touch. The disease may be accompanied by swelling of the joints.
The most effective drugs for the treatment of gout are fullflex, allopurinol and colchicine.
The drug has a wide spectrum of action, anesthetizes, gives anti-inflammatory and antirheumatic effects. It relieves pain during an attack of the disease, promotes the removal of uric acid from the body. Fullflex also lowers blood cholesterol levels and has a diuretic effect.
This effect is achieved by the components included in the preparation: extracts of fragrant martini, meadowsweet, birch, willow bark and horse chestnut, essential oils of juniper, sage and eucalyptus.
All components of the drug are plant-based, which ensures the safety of its use.
Fullflex is prescribed both internally in the form of capsules and externally in the form of a cream for rubbing into the affected joints.
The capsules are taken once a day with meals. The duration of treatment is one month.
Externally, the drug is used twice a day, rubbing in a circular motion into the diseased joint.
The drug is contraindicated in women in pregnancy and during lactation.
There were no side effects from taking the drug.
Allopurinol is used in the treatment of high uric acid and gout. The main active component of the drug - allopurinol accelerates the oxidation of xanthine, which contributes to its conversion into uric acid.
The drug is prescribed for oral administration, depending on the severity of the disease. With a mild course of the disease, the daily dose of the drug is 100-200 mg, for patients with a moderate form of gout, 400-600 mg are prescribed, with a severe course of the disease - 900 mg per day. The positive effect of the drug on the body is already noticeable a day or two after the first dose. The dynamics of the action of the drug is monitored by comparing the level of uric acid before and after taking the drug.
The possibility of treatment with allopurinol is not always available if a person has concomitant diseases. At the beginning of treatment, the doctor should carefully monitor the condition of the kidneys and liver of such a patient. If kidney function is reduced, then the dose of the drug is recommended to be halved.
During treatment with the drug, the volume of urine excreted from the body should reach two liters per day.
The drug is contraindicated in pregnant and lactating women.
Possible side effects from taking allopurinol: arterial hypertension, bradycardia (low heart rate), stomatitis, nausea, vomiting, indigestion, dizziness, headaches, weakness, sleep disturbance, depression and. In rare cases, taking the drug can cause swelling and the release of blood along with urine (uremia and hematuria).
Allopurinol does not relieve pain during gouty attacks, but contributes to their disappearance in the future.
It is necessary to take the drug by prescription and under the supervision of a doctor.
The drug is of plant origin and is an effective remedy for pain relief during gout attacks. Get colchicine from autumn colchicum.
The drug is taken during an attack of gout inside, at a dose not exceeding 1 mg. Two hours later, colchicine is repeated. The positive effect of the drug occurs three hours after administration and lasts twelve hours. The appointment of the drug more than the indicated dose is possible only after a medical examination, but taking more than 10 tablets during the day is not recommended.
Colchicine is safe for the body, one part of the drug is absorbed from the intestines, the other part is processed in the liver and excreted from the body.
Contraindications for use: hepatic or renal failure, hypersensitivity to the components of the drug.
Pregnant women should take the drug under medical supervision.
The drug has side effects that usually occur with an overdose: nausea, vomiting and indigestion, itching, urticaria, burning of the skin, a decrease in the number of leukocytes (leukopenia) or neutrophils (neuropenia) in the blood, sperm deficiency (zu men).
The use of the drug "Colchicine" in the treatment of gouty arthritis will quickly and effectively eliminate pain and inflammation, restore range of motion in the joint. Regular periodic courses will help to avoid relapses of gout in patients with a chronic course of the disease.
Composition, form of release and mechanism of work "Colchicine"
The therapeutic effect of the drug is achieved due to its main active element - colchicine. This substance has a plant nature and is an alkaloid extracted from the bulb of the common colchicum. The drug is sold in the form of coated tablets. Each of them contains 1 mg of the active ingredient. A total of 20 pieces per pack. Quickly absorbed in the gastrointestinal tract, the drug reduces the intensity of movement of white blood cells to the site of inflammation, and also stops the process of absorption of uric acid microcrystals by cells. It has the ability to reduce the production of uric acid and prevent its crystallization. The drug inhibits cell division and stops the formation of defective amyloid protein elements.
2 hours after taking Colchicine, a patient with gout feels a sharp improvement in his condition, which persists for 12 hours.
Ailments in which the drug helps
The drug relieves pain during an attack of the disease. Tablets "Colchicine" have a quick positive effect in the relief of acute attacks of gout. Regular intake can reduce the likelihood of relapse in most patients. The list of indications for the use of the drug includes such pathologies:
- violation of protein metabolism - amyloidosis;
- aphthous ulcers of the mucous membranes - Behcet's syndrome;
- inflammatory dental and ENT diseases;
- calcium deposits on articular cartilage;
- hardening of the connective tissue - scleroderma;
- inflammation of the venous walls;
- familial Mediterranean fever.
How to take "Colchicine" in the treatment of gout?
The medication regimen is prescribed by the doctor individually and depends on the form of the disease and the severity of the patient's condition. The drug is intended for oral administration, it can be taken regardless of food, preferably in the evening. You can not drink more than 8 mg per day. The dosage for the treatment of gout is different, more about it in the table:
In what cases is the medication prohibited?
The drug is contraindicated in the presence of kidney disease. To refrain from therapy with "Colchicine" is for people with individual intolerance, suffering from alcoholism, as well as the elderly. You can not drink medicine during pregnancy. The use of "Colchicine" in the treatment of gout with the following background pathologies is excluded:
- acute insufficiency of liver and kidney function;
- severe dysfunctions of digestion, heart and blood vessels, bone marrow;
- purulent type infections;
- agranulocytosis.
Side effects of colchicine
Taking the drug can provoke unwanted reactions from various body systems. Unpleasant sensations in most cases disappear with a decrease in the dose of the drug. If the symptoms are intense, you need to see a doctor for a replacement. List of possible side effects:
- dyspeptic manifestations: epigastric pain, lack of appetite, nausea, vomiting;
- disruption of the liver and kidneys;
- deviations in the composition of the blood;
- allergic skin rashes;
- hair loss;
- neuropathy;
- depressive state;
- muscle damage;
- lack of vitamin B12;
- absence of spermatozoa.
Treatment with "Colchicine" must be carried out under the control of blood counts with the help of regular tests.
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Introduction
Gout- a disease associated with an excess of uric acid in the body and the deposition of its salts in tissues (mainly in the kidneys and joints).There is currently no cure for gout. This disease forces to carry out a constant intake of medicines throughout life. Long-term use of drugs that normalize the level of uric acid in the blood is the main principle of the treatment of gout, because the abolition of drugs leads to the resumption of attacks of the disease.
There are two types of treatment for gout:
- treatment of an acute attack of gout;
- permanent anti-gout treatment.
Treatment of acute gout
An acute gout attack is treated with non-steroidal anti-inflammatory drugs, glucocorticoids, and colchicine.The choice of drugs for the treatment of an acute attack of gout depends on the severity of the disease, the presence of concomitant pathology, the presence of complications of chronic diseases, allergies and individual tolerability of the drugs.
During an acute attack of gout, it is necessary to provide the sore leg (arm) with an elevated position and complete rest.
Non-steroidal anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs in the treatment of gout are Reopirin, Butadion, Pirabuton, Vofapirin, Indomethacin, Diclofenac sodium, Movalis, etc. The Institute of Rheumatology of the Academy of Medical Sciences of Russia recommended the appointment of Nimesil (Nimesulide) for the treatment of acute gouty arthritis, as a highly effective and well-tolerated drug. The drug has a less pronounced, compared with other drugs in this group, toxic effects on the liver and kidneys. Nimesil (Nimesulide) can be used orally and intramuscularly, and is the drug of choice for the treatment of gout. A more pronounced anti-inflammatory and analgesic effect is observed when prescribing the granular form of Nimesulide compared to the tablet form.Colchicine
Colchicine is widely used in Europe. The drug is an extract of the bulb of meadow saffron. Previously, high doses of colchicine were prescribed, but this method of treatment had a number of complications (renal failure, reactive hepatitis, and others). Now an alternative treatment regimen with colchicine is used (small doses of it), they get a good effect and good tolerability of the drug even in the presence of renal pathology in the patient.With the ineffectiveness of non-steroidal anti-inflammatory drugs and colchicine or existing contraindications, glucocorticoids are used for their appointment.
Glucocorticosteroid hormones
Hormonal preparations (glucocorticosteroids) are recommended to be used in the form of 1 or 2 intravenous injections (depending on the severity of the process and the number of affected joints) of Methylprednisolone (Metipred). Can also be used Prednisolone, Dexamethasone, Prednisone, Reozolone (combined preparation of Prednisolone and Butadione). In addition to a quick, pronounced and persistent anti-inflammatory effect, the drug also has a uricosuric effect (promotes the excretion of uric acid salts).Given the likelihood of re-exacerbation during treatment with corticosteroid drugs and their side effects, the use of glucocorticoids is carried out in a hospital setting.
Local cryotherapy
It is also reasonable to use local cryotherapy (cold treatment) simultaneously with non-steroidal anti-inflammatory drugs in an acute attack of gouty arthritis. Cryotherapy - short-term exposure to low temperatures. It allows you to improve blood microcirculation in tissues, enhance metabolic processes. Cryotherapy has anti-inflammatory and analgesic effects. With local cryotherapy, the affected joint is treated with ice (temperature minus 180 o C) gas. Can be used and stay for 2-3 minutes in a cryosauna. In the absence of conditions for cryotherapy at home, you can apply a plastic ice pack to the diseased joint.
Painkillers
With severe pain, painkillers are prescribed.A patient with gout should have some anti-inflammatory and pain medication in the medicine cabinet, because a gout attack can start suddenly at any time.
Anti-gout treatment
Long-term anti-gout treatment and maintenance therapy in an individually selected dosage prevents the progression of gout and promotes the regression of tophi (deposits of uric acid crystals in the tissues in the form of dense nodes). Knots can soften and even disappear.You should start taking anti-gout drugs only in the interictal period. If a gout attack has developed against the background of ongoing treatment, then it is not necessary to cancel the drugs. When taking anti-gout drugs, it is necessary to consume at least 2-2.5 liters of fluid daily.
For the correct treatment of gout, it is necessary to determine its type (metabolic, renal or mixed).
In the metabolic type, gout develops due to excessive production of uric acid in the body. In the renal type, the disease is associated with insufficient excretion of uric acid compounds by the kidneys. With a mixed type, both of these causes take place; this type of gout is the most severe.
To determine the type of gout, the patient is prescribed a special diet and a complete exclusion of alcohol for 7 days. On the 6th and 7th day, it is necessary to collect separately the urine allocated per day. In each serving, the amount of excreted uric acid is determined, as well as its average daily excretion. If 600 mg or more (3.6 mmol) is excreted per day - metabolic type, if 300 mg or less (1.8 mmol) - renal type.
Anti-gout drugs are divided into 3 groups:
- uricodepressive (reduce the formation of uric acid);
- uricosuric (increase the excretion of uric acid);
- mixed action (reduce the formation and increase the release of uric acid compounds).
Uricodepressive agents
Uricodepressive agents include Allopurinol, Thiopurinol, Hepatocatalase, Orotic acid.Indications for their appointment are:
- gout with damage to large joints and large nodes;
- gout (primary or secondary) in blood diseases;
- nephropathy (kidney disease) with increased excretion of uric acid;
- urolithiasis with urate stones;
- chemotherapy for blood diseases (leukemia), lymphomas, malignant neoplasms in order to prevent increased excretion of uric acid and manifestations of gout.
Allopurinol- tablet preparation. Doses of Allopurinol depend on the severity of the course of gout, the content of uric acid in the blood and kidney function. Therefore, only a doctor can choose the dose of the medicine. Normalization of indicators of the level of uric acid in the blood is achieved after taking the medicine for 4-6 months, and a decrease in the frequency and severity of attacks, resorption of nodes - after 6-12 months. Treatment with Allopurinol has been carried out for many years with short breaks (for 2-3 weeks), because. with each exacerbation of gout, the severity of the course of the disease increases and the possibility of developing complications with a threat to life increases. Tolerability of the drug is good.
In the first 10 days of the start of treatment with Allopurinol, articular crises may occur (this is due to the removal of urates from the tissues and their crystallization). To prevent their occurrence, Colchicine or non-steroidal anti-inflammatory drugs are prescribed until the normalization of uric acid levels in the blood.
Uricosuric drugs should not be taken simultaneously with Allopurinol, because they reduce the effectiveness of the first. Allopurinol is contraindicated in pregnancy and in violation of liver function.
Thiopurinol(also a tablet preparation) has the same activity as Allopurinol, but the drug is better tolerated by patients.
Hepatocatalase(preparation from beef liver) is less active compared to Allopurinol, it is administered intramuscularly 2-3 times a week.
Orotic acid, as well as Allopurinol, reduces the synthesis of uric acid and at the same time enhances its excretion, but a less active agent compared to Allopurinol. It is used before meals in the form of granules or tablets. The drug is taken for 20 days, then take a break for 20 days and repeat the course. Tolerability of the drug is good, but the effectiveness is weak. Orotic acid also lowers blood cholesterol levels. The drug is usually prescribed when Allopurinol is contraindicated or if it is poorly tolerated.
Uricosuric agents
Uricosuric agents reduce the reabsorption of urate in the tubules of the kidneys and, as a result, increase the excretion of uric acid by the kidneys. Indications for the appointment of uricosuric drugs:
- renal type of gout (in the absence of pronounced manifestations of gouty nephropathy);
- mixed type of gout (with daily excretion of uric acid less than 450 mg or 2.7 mmol;
- intolerance to Allopurinol.
Uricosuric drugs include high doses of salicylates (Aspirin, Butadione), Anturan, Ketazon, Benemid (Probenecid), Flexin, Atofan, Urodan.
Application salicylates, and even more so in large dosages, is limited due to the severity of side effects from the gastrointestinal tract. In small doses, they, on the contrary, increase the level of purine compounds in the urine and increase their content in the blood.
In the initial period of treatment, articular crises may develop, to prevent their occurrence, it is recommended to take Colchicine or Colbenide (contains both Colchicine and Benemide in 1 tablet).
It is advisable to combine the appointment of Butadion and Benemid. Benemide is generally well tolerated, but may also have digestive and allergic reactions. The appointment of Benemid is contraindicated in case of frequent joint crises, pregnancy, chronic renal failure and high levels of uric acid in the blood (above 800 mg per day).
Allopurinol slows down the breakdown of Benemid in the body and therefore enhances the effect of their combined use.
Anturan(sulfinpyrazone) should be taken after meals with milk, but it also has gastrointestinal side effects. Therefore, peptic ulcer of the duodenum or stomach is a contraindication for its appointment. It is not prescribed for severe damage to the kidneys and liver.
The combined use of Anturan and Benemid has a more pronounced effect than with their isolated appointment.
Etamid also helps to reduce the content of uric acid in the blood and its excretion in the urine. It is prescribed for 10-12 days, then a break for 5-7 days and a second dose of the drug. During the year, such treatment is carried out 3-4 times. The drug is well tolerated.
Dezurik(Benzobromarone) has a strong uricosuric effect by reducing the reabsorption of uric acid in the renal tubules and, in addition, blocks the enzymes involved in the synthesis of uric acid. The drug also promotes the release of uric acid compounds through the intestines. In the first days of treatment, there may be an increase in pain in the joints. In this case, non-steroidal anti-inflammatory drugs should be taken. The drug is well tolerated, but there may be adverse reactions from the gastrointestinal tract or allergies. Benzobromarone is contraindicated in renal and hepatic insufficiency.
Urodan(easily soluble granules) promotes the excretion of uric acid and alkalinization of urine. The course of treatment is 30-40 days (repeated if necessary).
Ketazon enhances the excretion of purines in the urine and has an anti-inflammatory effect.
Improvement in well-being occurs after 3-4 weeks from the start of taking uricosuric drugs.
Mixed action anti-gout agents
A mixed action anti-gout agent is Allomaron(combined preparation containing Benzobromarone and Allopurinol). The action of the drug is twofold: it reduces the synthesis of uric acid compounds and increases their excretion in the urine. This combination of two drugs eliminates the formation of kidney stones and reduces the risk of side effects of Allopurinol. Taking this drug does not require mandatory heavy drinking and alkalinization of urine. Only if patients have urolithiasis, they need to consume 2.5 liters of fluid and alkalinize urine in the first 2 weeks. Allomaron is more effective than Allopurinol or Benzobromarone monotherapy. After 3-4 weeks, normal levels of uric acid in the blood are achieved. The duration of the course is determined by the doctor individually (3-6 months or more).Allomaron is used for any origin of gout. The drug is contraindicated in pregnancy, lactation, chronic renal failure, individual intolerance and under the age of 14 years. The drug is well tolerated, adverse reactions are rare. At the beginning of treatment, joint pain may increase due to the consumption of uric acid salts from gouty nodes (tophi). In these cases, Indomethacin or Colchicine is used.
Alternative treatments for gout
Of the non-traditional methods of treating gout, one should name acupuncture, herbal medicine, spa treatment. Acupuncture with gout, it helps to eliminate the inflammatory process in the diseased joint, which means it reduces the pain experienced by the patient. Under the influence of this type of treatment, the metabolism in the affected joint is normalized. But acupuncture can be used only outside the exacerbation of gout.
Spa treatment also carried out only in the interictal period. In sanatoriums, mineral water treatment and mud therapy are used. Radon, iodine-bromine and sodium chloride baths are prescribed (general, 4-chamber, 2-chamber). Under the influence of these procedures, blood supply and tissue nutrition in the joints improves, kidney function improves, uric acid excretion increases, movements in the joints improve. Showers are widely used (Charcot, underwater, jet). Physiotherapeutic methods, physiotherapy exercises, massage are widely used.
Patients with gout are shown such resorts: Pyatigorsk, Tinaki (Astrakhan region), Yalta, Odessa, Evpatoria, Yangan-Tau (Bashkiria) and others. Sankur treatment is contraindicated in chronic renal failure and difficult to correct high blood pressure.
Phytotherapy: traditional medicine recommends using for the treatment of gout
With a disease such as gout, drug treatment is aimed at relieving symptoms, prolonging the period of remission, and reducing the number of exacerbations. Means of both systemic and local action are used. How to treat gout on the legs?
Treatment of gout
Continuous use of minimal doses of Colchicine helps to reduce the frequency of attacks, such therapy is most effective in subintroductory and polyarticular forms of the disease. Continuous treatment is not addictive, and the drug retains its effect in acute types of gout. Colchicine can cause leukopenia and anemia, so a complete blood count is recommended at least once every 6 months.
From gout, drugs of the hypouricemia group relieve quickly, which is associated with the effect not on the symptoms, but on the cause of the disease. There are 2 types of such funds:
- excreting increased amounts of uric acid through the kidneys
- inhibiting the production of this substance.
The former prevent the absorption of urea into the blood, they are ineffective in the presence of renal failure. Uricosuric tablets are most commonly used to treat chronic gout.
Probenecid blocks the tubular absorption of urate and increases the amount of uric acid excreted by the kidneys. Tablets are taken in minimal doses 2 times a day, after a week the dosage is increased by 2 times. The drug has no serious side effects, it is easily tolerated by the body. In rare cases, there may be increased sweating, allergic reactions and a decrease in blood pressure. It is necessary to constantly monitor the state of the excretory system. When the first signs of renal failure appear, Probenecid is replaced by Allopurine. Etebenecid has a similar effect, many experts believe that it gives fewer side effects.
Allopurinol is a drug that inhibits the production of uric acid. The dose is selected by the attending physician. It is recommended to start with a minimum, gradually increasing it. Tablets are taken 2-3 times a day, the treatment of gout on the legs lasts 3-4 weeks. Allopurinol can be used in combination with colchicine. The first drug is well tolerated, in rare cases allergic reactions, skin rashes, neuritis occur.
The therapeutic effect of Allopurinol is due to the effect on the enzyme that converts hypoxanthine to uric acid. The use of this remedy does not lead to the formation of salts, so it can be used to cure gout without the risk of nephrolithiasis. Allopurinol has a pronounced anti-inflammatory effect. It relieves pain and swelling, eliminates redness of the skin.
Indications for the use of the drug are:
- the presence of large salt deposits;
- an acute attack of gout that cannot be controlled with standard uricosuric agents;
- intolerance to Probenecid;
- production of an increased amount of uric acid;
- uric acid nephrolithiasis;
- chronic and acute renal failure.
Some experts believe that these tablets can cause xanthine lithiasis. Complex drug treatment of gout can save the patient from attacks for a long time, but it does not eliminate metabolic disorders, so the therapeutic course can last several years, or even for life. Cancellation of drugs contributes to the rapid increase in the level of uric acid in the body, and the pain may reappear.
NSAIDs have fewer side effects, which eliminate pain in acute gouty attacks. The most effective drugs are pyrazolone series. During an exacerbation, tablets are taken every 6 hours at maximum doses. However, even in this case, NSAIDs cause less pronounced side effects than Colchicine. With the appearance of undesirable consequences, one remedy can be replaced by others, which increases the effectiveness of treatment.
If the pills described above are ineffective, the attending physician may decide to prescribe hormonal drugs that quickly eliminate the symptoms of the disease. Gout can be cured with a single injection or a short-term therapeutic course. Hormones relieve arthritis and pain.
An attack of gout significantly worsens the general condition of the patient, glucocorticosteroids allow you to return to your usual lifestyle in 2-3 days.
Remedies for gout
Ointments and solutions can eliminate pain and inflammation, relieve swelling and restore joint mobility. Butadion-based cream is applied to the affected area 3-4 times a day.
It is necessary to start treatment with the minimum doses of the active substance. This will help avoid severe allergic reactions.
Means treat the skin without rubbing it. There is no need to use a warming bandage. However, you need to protect your feet from direct sunlight. Diclofenac ointment is considered no less effective. 1 g of this medicinal product contains 10 mg of the active substance. A small amount of ointment is evenly distributed over the skin of the affected area. It is rubbed with light massage movements. With strong pressure or sudden actions, the pain may intensify.
During the day, the ointment is applied 2-3 times, its total amount should not exceed 8 g. Nonsteroidal anti-inflammatory substances can penetrate into the bloodstream, which leads to side effects. Safer and more effective medicines for gout are based on natural plant extracts. These include Fullflex. It can be used in the presence of allergic reactions to chemicals. The ointment has a pronounced anti-inflammatory and anti-edematous effect.
Preparations of systemic and external action should be selected by the attending physician.
Gout, or gouty arthritis, is a disease that affects the joints of a person due to the deposition of salts. Despite the very familiar name, which is widely heard, three out of a thousand people suffer from gout. According to the age criterion, the disease is more common in people over 40 years old, there is no separation by gender - both men and women suffer from gout. The most common location of the disease on the human body is the toes.
Causes
Many factors can precede the development of gout. Among people at risk - people with diabetes and hypertension. The disease has the ability to be inherited, so it is worth considering the hereditary factor. Foot gout can occur due to excessive stress on the feet. Older people are more likely to suffer from gouty arthritis of the feet. In addition, an unbalanced diet and, as a result, a disturbed metabolism in the body can affect the development of gout and aggravate it. Not only will these factors influence which gout remedy will be most effective in treating it, but also what symptoms accompany the disease and what degree it has reached.
Symptoms of gout
The disease for a very long time may not show any signs and appear quite suddenly, while with very noticeable painful phenomena. The main symptom of the onset of the disease is swelling and fever in the area of \u200b\u200bthe diseased joint. In most cases, fever and severe pain are reported at night. Moreover, the joint is so sensitive to any touch that even a light sheet can cause acute pain. Subsequently, a tingling sensation is added to severe pain and a feeling of heat in the joint.
If you ignore this symptomatology and do not make any attempts at treatment, then the attacks will appear more often, and the disease will affect more and more new areas of the joints. The advanced stage of gouty arthritis often leads to such complications in the human body as kidney and urinary tract diseases.
Despite the latest technologies in pharmaceuticals and the effectiveness of treatment, it is impossible to completely overcome gout, it becomes chronic, but it is possible to alleviate the condition and slow down the development of gout with the right pills.
Treatment of gout
Symptoms indicating the possibility of a disease should, first of all, provoke a person to go to the doctor. After prescribing an appropriate examination and confirming the diagnosis, doctors, in accordance with the degree of the disease, prescribe medications to the patient that have a multidirectional effect. Tablets for gout should have at least a three-component effect - the prompt elimination of painful sensations, the prevention of possible attacks, the suspension of long-term complications.
Each person, neglecting the treatment regimen, is responsible for their own health and life. Failure to take medication leads to the destruction of the kidneys and further damage to the joints. Proper treatment, fulfillment of all the doctor's instructions lead not only to the elimination of pain, but also to the possibility of forgetting about it for a long time or, perhaps, forever.
Medicines for gout
To date, despite the development of medicine and the latest technology in the manufacture of medicines, there are not many drugs used to treat gout. According to their action, they are classified into temporary and long-acting drugs. Short-term medications can quickly relieve pain. With the elimination of seizures, painkillers, anti-inflammatory drugs, which have not only an analgesic effect, but also eliminate the focus of inflammation, are struggling.
In turn, long-term medications help relieve not so much pain as they reduce the level of uric acid in the blood plasma and, as a result, slow down the development of the disease and eliminate complications.
Colchicine
In modern medicine, colchicine is one of the best medicines used to fight gout. The drug belongs to the tropane alkaloids and has an analgesic effect, and also neutralizes the formation of salt deposits in the tissues and minimizes the migration of leukocytes in the affected area. The drug was created on a plant basis, containing in its composition the main component - autumn colchicum, so it can be used not only for therapeutic, but also for prophylactic purposes.
It is quite well tolerated by patients, and in addition to the therapeutic effect, it has high safety indicators for health. The effectiveness of the drug largely depends on the correct administration. As soon as the disease is diagnosed, colchicine should be taken on the first day every hour. It should be borne in mind that the maximum daily dose should not exceed 10 tablets. The course of treatment with colchicine ends when the desired result is achieved and as prescribed by the doctor.
As a fairly effective drug that acts and is excreted by the kidneys, it is contraindicated in people with renal and hepatic insufficiency, as well as with individual intolerance to the components of the drug. It is worth taking colchicine with caution during pregnancy and only after the permission of a doctor. An overdose of the drug or the presence of contraindications can aggravate the condition and cause vomiting, diarrhea. The appearance of other side effects should cause a person to stop taking the medicine immediately and consult a doctor. In addition, the drug should not be taken very long in duration. In this case, it can cause the threat of anemia and leukopenia.
Allopurinol
Allopurinol does not help relieve pain, but in turn it lowers uric acid levels and also serves as a protective barrier to possible complications of gout. Treatment should begin with a minimum daily dose of 100-300 mg, which must be divided evenly throughout the day into 3 doses. On the recommendation of a doctor and the absence of side effects, the dosage can be increased - up to 100 mg every two weeks. In this case, the maximum daily dose should not exceed 800-900 mg. The therapeutic effect can be achieved with proper treatment without missing tablets during the first month of taking the drug, given that the daily dose should not be less than 200-600 mg.
Patients taking allopurinol need to take a blood test every month to determine the level of uric acid. By the way, a decrease in this indicator will already be noticeable in the first month of treatment.
Despite the broad effect of the drug, its use should be prescribed by a doctor with special care. A person should not have other concomitant diseases that can be aggravated by taking allopurinol. In addition, it is contraindicated in liver failure and during a gouty attack.
Allopurinol analogues are thiopurinol, anturan and hipurik.
Fullflex
The best of its kind is a very popular and recently replicated drug fullflex. It is convenient because it comes in two forms - in the form of a cream and tablets - and allows you to fight the disease not only from the inside, but also from the outside. The drug belongs to the means of short-term action and has a simultaneous, analgesic and anti-inflammatory effect. The composition of the medicine includes extracts of such plants as fragrant martinia, willow bark, birch bark, horse chestnut, as well as essential oils of eucalyptus, sage and juniper, which in many ways safely affects the human body. In addition, among its components are vitamins E and PP. By the way, fragrant martinia has been used since ancient times as a remedy that effectively fights inflammation and swelling in certain areas of the body. This plant was especially widely used in the East.
The drug is taken for a month at the rate of one tablet per day, the cream is rubbed twice a day. Fullflex is contraindicated in pregnant and lactating women.
Voltaren
Temporary relief of attacks of gouty arthritis is possible with the help of Voltaren. The effect is achieved by the simultaneous administration of tablets and ointment of this drug. To achieve a clear result, it is recommended to take the maximum dose of 200 mg on the first day, then 150 mg per knock, and also rub the sore joint with a cream twice.
Ibuprofen and diclofenac have a similar effect, which relieve inflammation, relieve swelling and pain, and also reduce temperature. Naproxen adheres to the same scheme. All these drugs are strictly contraindicated during pregnancy.
The effectiveness of treatment, up to the exclusion of all kinds of attacks later, largely depends not only on compliance with dosed norms, but also on the duration. It would be extremely imprudent to stop drug therapy when the symptoms disappear and you are sure that the disease has receded. Even when the pain is stopped, the drug should continue to be taken until the end of the course. Meeting the deadlines, the lack of self-treatment without supervision by a doctor will allow you to effectively fight gout, forgetting about pain forever.
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- Indications
- Contraindications
- Dosage
- Side effects
- Interaction
- special instructions
Colchicum - dispert - a tablet preparation of natural origin, which should be taken only according to the instructions for use. This drug affects the metabolism of uric acid and is often used to treat gout.
In the composition - colchicum seed extract, dried and crushed. The alkaloid colchicine is also obtained from it, which has the same anti-gout effect.
Indications
The main indication is an acute attack of gout. Usually, drugs for this disease are taken for prevention and outside the attack. And only Colchicum - dispert should be taken during the attack itself, so that it ends faster, and the level of uric acid at the same time drops to the lowest possible level.
The second indication for admission is familial Mediterranean fever.
Contraindications
In the instructions for Kolchikum - dispert there is information about when these tablets should not be drunk. This section should be read carefully and be sure to consult a specialist:
- Hypersensitivity to the components of the drug.
- Pregnancy.
- Liver failure.
- Feeding the baby with breast milk.
- Renal failure.
- Violation of cerebral hematopoiesis.
The drug should be used with great caution in the treatment of the elderly, those who have cachexia and disorders in the gastrointestinal tract, as well as problems with the heart and blood vessels.
Dosage
Tablets should be taken whole, without chewing. In an acute attack of gout, take 2 tablets at the first dose, and then 1 to 3 tons every hour, until the attack of pain passes.
Each 2 tablets is 1 mg of colchicine. In total, no more than 8 mg can be taken per day. Repeated treatment with the same number of tablets and in the same dosage can be used only after 3 days.
The drug can also be used to prevent exacerbation of gout. It should be used for several months simultaneously with uricosuric agents. In total, 1 to 3 tablets are allowed per day. The duration of therapy can be up to 3 months.
Side effects
The instructions for the use of colchicum contain information that side effects rarely occur and only with the wrong dosage. Among the main manifestations - nausea, diarrhea, a decrease in the number of leukocytes in the blood, myopathy and agranulocytosis are observed with long-term treatment. Men may develop baldness.
Interaction
When taken simultaneously with cyclosporine, there is a high probability of developing impaired renal function. When combined with cyanocobalamin, the absorption of the latter almost completely stops.
NSAIDs, and any, can cause a violation of hematopoiesis, which causes leukopenia and thrombocytopenia.
When taken with cytostatics, the effectiveness of colchicum decreases, which is displayed in the instructions. The concentration of uric acid rises several times and the urine becomes acidic.
But colchicum is recommended to be used with drugs such as allopurinol and the like. In this case, the action of both will be enhanced, which means that it will be faster to get rid of the increased concentration of uric acid in the blood.
special instructions
Treatment is carried out only as prescribed by a doctor, in a hospital, with constant monitoring of blood tests. If any side effects occur, the drug should be discontinued or the dosage reduced. With a decrease in the level of leukocytes and platelets, the medicine is also canceled.
Even with prolonged use, colchicum does not affect the ability to drive a car in any way.
For any violation of the kidneys can not be used. The medicine Kolhikum - dispert according to the instructions is not recommended for use in the treatment of elderly patients over 60 years of age.
Analogs are:
- Colchicine.
- Bryony.
- Texamen.
- Fullflex.
- Antisol.
- Purinol.
- Klofezon.
- Rumakar.
- Ugly.
- Allopurinol.
Almost all analogues are highly effective, but before using them, you must read the instructions. This is one of the most effective remedies for stopping a gout attack. In 80% of all patients, the general condition improved markedly after the first day of using this remedy.
But in 80% of cases, there is a chance that the overall improvement will be simultaneously manifested with side effects such as nausea, vomiting and diarrhea. After removing the attack, the pills should be taken for preventive purposes. To do this, use 1 - 2 mg for daily intake.
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Gout is a disease of the joints, which consists in the pathological deposition of uric acid salts. According to statistics, three out of 10 people get it, and gout in women is much less common. In men, the disease appears after the age of 40, and in women - during menopause.
The lesion occurs in any joints. It can be both fingers and hands, and elbows, knees and feet. Gout most commonly affects the joints of the fingers of the lower extremities. At risk include people suffering from arterial hypertension, diabetes, alcoholism. What are the symptoms and treatment of such a disease, we will analyze below.
Causes of the disease
The reasons that can contribute to the development of such a disease are quite diverse:
- Some medications can cause gout to develop. These include Aspirin, diuretic diuretics, cyclosporines;
- diabetes;
- ischemic disease;
- obesity;
- chronic renal failure;
- metabolic syndrome;
- excessive consumption of fatty meat, seafood, soda, alcohol;
- hereditary predisposition.
Exacerbation of the disease can be observed with trauma and surgery. There are two types of disease: primary and secondary. In the first case, gout occurs as an independent disease, and in the second case, as a consequence of an existing other disease or medication.
Symptoms and course of the disease
The first sign of gout is a pain syndrome that occurs suddenly and acutely. With damage to the lower extremities, pain is felt in the area of the metatarsophalangeal joint, especially at night. There is also pronounced swelling, the skin becomes red and begins to peel off. All signs and symptoms occur fairly quickly and are accompanied by symptoms such as chills, fever, and fever. Signs of gout are also diagnosed in the blood. So, leukocytosis and an increase in ESR appear.
After about a week, all symptoms subside, and after ten days they completely disappear.
Not always the lesion occurs in the joints of the lower extremities. Other areas are the knee and elbow joints, as well as the joints of the hands. You can also note the following forms of the disease:
- Rheumatoid-like: joints of the hands, medium and large joints.
- Pseudo-phlegmonous: a lesion of the type of monoarthritis - medium and large joints.
- Periarthritic: damage to tendons not involved in the joints.
- Subacute: big toe.
- Asthenic: joint damage is accompanied by an unexpressed pain syndrome, lack of edema.
- Infectious-allergic: it is considered an independent disease, which is characterized by rapid sequential damage to the joints.
- Form - polyarthritis: according to the type of allergic or rheumatic form with rapid regression.
There are cases when the lesion occurs simultaneously in many joints, but basically it is sequential. In addition, the tendons are affected, moreover, there is a seal and soreness. In the period between attacks of gout, a person feels good.
As the disease progresses, such remissions become shorter and shorter. Along with this, the deformation of the joint develops and it becomes stiff. Edema is persistent, and intra-articular effusion is also observed.
In 80% of cases of gout, there is such a concomitant pathology as deforming spondylosis. The disease is accompanied by damage to the spine, namely its vertebrae.
The following comorbidities can also be distinguished - gouty nephropathy or gouty kidney, nephrolithiasis, renal failure, arterial hypertension, cardiac ischemia, hypertension, cerebral sclerosis or obesity.
Diagnosis of the disease
Personal inspection. An anamnesis is necessary to exclude the presence of other pathologies that have a similar manifestation with gout. To do this, the doctor finds out such questions: what were the first signs of the disease, how did they appear, did relatives have cases of illness, does the person have bad habits, does he eat right, the presence of other pathologies before, including kidney ones, were any operations performed.
The clinical picture of the development of gout (determination of the stage of gout, the characteristic course).
Instrumental and laboratory research. Instrumental studies include: ultrasound, tomography, x-rays. Laboratory studies - this is a general blood test, a biochemical blood test, a general urinalysis, a biochemical urinalysis, a study of the synovial fluid of the joint.
Treatment
How to get rid of gout? It is recommended to get rid of any disease, including gout, in a complex way, that is, it is necessary to use all methods of treatment. One of them is medication. You can name the following remedies for gout.
From non-steroidal drugs, such as Diclofenac, Ibuprofen, Nimesulide should be distinguished. Non-steroidal drugs relieve pain syndrome and reduce swelling. Such remedies are only symptomatic, that is, not capable of treating gout. That is why nonsteroidal drugs are used in combination with other drugs.
Colchicine is a drug that helps to influence the process of inflammation and restore the normal functioning of the damaged joint. Colchicine is prescribed at the first stage of the course of the pathology in order to understand its positive or negative effectiveness.
Treatment with hormonal drugs is prescribed for the ineffectiveness of Colchicine. Hormone medication will also help reduce inflammation in the affected area. These include Betamethasone and Methylprednisolone. But it is worth noting that the funds can cause side effects. To prevent such manifestations, taking a remedy containing hormones is prescribed once or in a short course.
Allopurinol is a drug that helps eliminate excess uric acid in their body. The medicine is taken for several months.
How to eat when sick?
Probably the best remedy for gout is proper nutrition. It is recommended to have breakfast, lunch and dinner at the same time every day. In this case, portions should be small. It is better to eat more often, but in small portions.
Nutritionists are of the opinion that with a disease such as gout, it is important to limit oneself in the consumption of foods that are rich in purines, these are compounds that are involved in the synthesis of uric acid. Limit the intake of purines for healthy people - up to 800 mg per day, and for people suffering from gout - no more than 150 mg.
- tea, coffee, cocoa.
- chocolate.
- legumes, rice
- any meat, liver, tongue.
- sardine, herring, sprats.
- spinach and asparagus.
Honey is no less dangerous for such a disease, since it is rich in oxalic acid. Spicy foods and alcohol are also not recommended. During the period of exacerbation of the disease, it is forbidden to eat any meat and fish.
However, there are also useful products that are necessary for gout. These include any porridge, bread, muesli. Vegetables, fruits, nuts, herbs (excluding sorrel), as well as berries such as lingonberries, strawberries, currants.
The best menu according to nutritionists is diet number 6.
Its essence is as follows - limiting the consumption of proteins, for example, legumes and meat. Animal proteins should be included in the diet at half the rate for people who do not have gout. Refractory fats also need to be limited. These include pork, lamb, beef and culinary. It is recommended to include butter and vegetable oil in the diet.
Limit your intake of food containing oxalic acid. Mushroom, fish and meat broth is a forbidden food for gout. In the absence of impaired functioning of the kidneys and heart, it is recommended to drink at least 2 liters of fluid per day. Refusal to use salt. Include soy products and garlic in your diet.
Physiotherapy
In addition to medications and diet, physiotherapy is also used. Hardware treatment is also indicated in the acute stage, including procedures for infrared and ultraviolet irradiation, UHF and phonophoresis with corticosteroids. After the acute pain syndrome is eliminated, the doctor prescribes ultrasound and laser treatment, which improves microcirculation and metabolism in the tissues of the joint.
Laser treatment is necessary when microcrystalline arthropathy is diagnosed, which mainly develops in old age. This is necessary due to the fact that at this age the risk of developing side effects from taking drugs increases.
Modern medicine does not stand still. So, researchers have invented physio-devices that can be used at home.
The compactness of such devices allows you to influence the affected area with a magnetic field or microvibration.
Folk remedies
Treatment of gout with folk remedies includes the use of compresses, baths, ointments. Compresses can be done as follows. Mix salt and honey in a 1:1 ratio, apply on gauze, and then on the affected joint. The recommended number of procedures is 15. Garlic helps with gout. Grind the garlic to a pulp, pour it with table vinegar and leave to infuse for two weeks. Use as a compress 2 times a day.
Baths can be made on the basis of such components. A decoction of chamomile, which can be done like this: 50 g of dry chamomile is poured with five liters of boiling water and boiled. After cooling, you can add to the bath. Decoction of sage. Dissolve soda (4 teaspoons) and iodine (10 drops) in water.
You can prepare a rubbing for treatment in the following ways. Grind activated charcoal (tablets) to make half a glass. Stir in one tablespoon of flax seeds (ground) and add a little water. Rub the product into the affected area before going to bed. Mix iodine tincture and Aspirin. To carry out rubbing before going to bed, warming the affected area from above.
The use of such drugs inside should be agreed with the attending physician, who will determine the dosage and duration of treatment.
Prevention
Prevention of a disease such as gout should, first of all, include diet. Consume enough fruits, vegetables, cottage cheese, yogurt. Eat wholemeal bread. Sufficient fluid drinking - up to 2.5 liters per day. It is water that dilutes uric acid in the blood. Water also supports the functioning of the kidneys, which prevents the formation of stones in them. Refusal of alcohol. Limiting salt intake.
It is no less useful to play sports. It can be walking, cycling, swimming, gymnastics. Wearing the right footwear will help prevent the development of gout. Timely treatment and prevention of gout indicate a favorable prognosis in the future. With untimely treatment, disability can be established.
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