Specific drug for GOUT?

Sir/Madam,

1). Can you tell any specfic drug for gout disease? or

2). If there is no specific drug means WHY?

Here are some resources about gout. The paragraph below summarizes some of the drug options for acute gout:

http://www.arc.org.uk/arthinfo/patpubs/6015/6015.asp

http://emedicine.medscape.com/article/329958-overview#section~Medication

The drug options for acute gout are of nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine and oral glucocorticoids, or intra-articular glucocorticoids administered via a joint injection.

NSAIDs such as diclofenac, etoricoxib, indomethacin, ketoprofen, naproxen or sulindac may be prescribed. For those at risk of gastric irritation from NSAIDs, an additional proton pump inhibitor may be given.

Colchicine remains a second line drug in the UK for those unable to tolerate NSAIDs, but its side effect profile has resulted in its role being relegated, at least in the US, to after that of oral glucocorticoids. It impairs the motility of granulocytes and can prevent the inflammatory phenomena that initiate an attack. Colchicine should be taken within the first 12 hours of the attack and usually relieves the pain within 48 hours, although side effects (gastrointestinal upset such as diarrhea and nausea) can complicate its use. NSAIDs are the preferred form of analgesia for patients with gout.

A randomized controlled trial found similar benefit from nonsteroidal anti-inflammatory drugs (single injection of diclofenac and then oral indomethacin) as from the oral glucocorticoid prednisolone; however, less adverse drug reactions occurred in the glucocorticoid group.

Another possibility is acetazolamide, one of the first diuretics discovered. This drug inhibits the action of carbonic anhydrase on the proximal convoluted tubules within the kidneys, which effectively inhibits reabsorption of bicarbonate, thus alkalinizing the urine. After two to three days of usage, the diuretic effects of this drug decline because of increased downstream reabsorption of ions and water by the renal tubules; however, the alkalinization of urine persists, and this basic urine attracts weak acids such as uric acid and cystine into the urine, thus increasing their urinary excretion.

Thanks for your kind information sir, but i want to know is there any drug for GOUT without or less side effects?

I don't think there is ANY drug for any disease without a side-effect.

As I mentioned in the summary above, side-effect wise a simplistic understanding seems to be: glucocorticoids < NSAIDS < Colchicine, i.e., glucocorticoids seem to be the best drug with minimal side-effects.

Please share with us your thoughts and your own research about gout.

Though pain relief is usually important for gout sufferers, it is more important to seek urate lowering therapy.

Unless uric acid is lowered, uric acid crystals will slowly build up to a point where joint damage occurs.

The most common treatment is allopurinol, which prevents the production of uric acid. Other medications, uricosurics such as Probenecid and Sulfinpyrazone, encourage the body to excrete uric acid. New treatments are available (or becoming available, depending where you live), including febuxostat.

It is important to get treatment from a gout specialist, usually a rheumatologist. Most treatment failures are due to inappropriate dosing, or patient noncompliance because the condition has not been adequately explained.

Uric acid must be reduced below 6mg/dL to get rid of existing uric acid crystals. This can take several months, during which gout flares will still occur, with reducing frequency and severity. After 3 months without flare, dose can be adjusted to maintain uric acid below 7mg/dL.

There is more information on my website, and a Gout Discussion section.

Hi, I have used allopurinol for the gout, which is induced by high protein diet in poultry. it gives excelent result.

Regards.

See Colchicine also

Yes, colchicine is effective at relieving gout pain, but it does nothing to reduce uric acid.

It  is a useful supplement for the first few months of uric acid lowering therapy as, during this time, old uric acid crystals should be dissolving, and this process can trigger another gout flare.

  I read recently (maybe in nature medicine or biotech, I'm not sure) that there are 3 new therapies coming.  I don't know if they will be any better or just more expensive.   Here's a related article that I could find quickly.

www.msnbc.msn.com/id/10366995/

 Febuxostat with allopurinol has been found to excrete more of urate from the body (I mean blood) and hence a better possible therapy for gout. This combination is even good for those having weak kidneys.

Gout is a disease in which uric acid, a waste product that normally passes out of the body in urine, collects and forms crystals in the joints and the kidneys. When uric acid crystals build up in the joints, the tissue around the joint becomes inflamed, and nerve endings in the area become irritated, causing extreme pain. Uric acid crystals in the kidneys can lead to kidney stones and eventually to kidney failure. Non-steroidal Anti-inflammatory Drugs, Corticosteroids or Colchicine have been used for the treatment. Three main types of drugs are used in treating Gout. Colchicine helps relieve the symptoms of gout by reducing inflammation. Allopurinol (Lopurin, Zyloprim) reduces the amount of uric acid produced in the body. Probenecid (Benemid, Probalan) and sulfinpyrazone (Anturane) help the body get rid of excess uric acid. Physicians may recommend that patients take more than one type of gout drug at the same time. Some of these medicines may also be prescribed for other medical conditions that are caused by too much uric acid in the body.