Experts still haven’t reached a consensus on when to start treatment for chronic gout. Discomfort in a patient occurs only during “attacks”. Some experts consider that gout should be treated when the first attack occurs. Treating the condition in the early stages can solve the problem quickly. According to another group of doctors, treatment should be started only after several gout attacks.
Hyperuricemia with gouty arthritis can lead to severe bone damage. The disease also affects cartilage. In this case, the patient requires urgent treatment. The areas with urate deposits only increase as the disease progresses. X-rays allow physicians to determine the severity of hyperuricemia.
Diagnostics help identify signs of the disease in approximately 40 percent of patients before subcutaneous tophi formation. During the examination, specialists can evaluate the patient's condition. The frequency of gout attacks doesn’t affect the degree of bone damage.
Allopurinol helps reduce the concentration of uric acid in human serum. But taking this drug in the acute stage can trigger an attack of the disease.
Doctors prescribe Allopurinol only in cases when the patient has no signs of inflammation. As an additional drug, Colchicine is used. It’s recommended at a dosage of 0.5 mg, 3 times a day. These drugs help prevent gout attacks.
The dosage of hypouricemic drugs should not be exceeded. The maximum concentration of uric acid in serum should not exceed 420 µmol/l, otherwise the crystallization of urates begins in the tissues.
To best help the patient, measures should be taken to lower uric acid concentration until 420 µmol/l. The process of dissolving urate crystals will only begin at these concentrations.
A positive treatment result is a resolution of the gout attacks. The patient gradually eliminates the tophi. Previously, the treatment of hyperuricemia was to take hypoglycemic drugs. The patient was advised to follow a strict diet.
Now, food restrictions do not have such a strong effect, as more effective treatmentshave been developed since . But that does not mean that patients may drink alcohol during treatment. Diabetes and obesity can complicate the treatment for hyperuricemia. The most popular remedy for this disease is Allopurinol. The therapeutic effect of this drug acts by suppressing the activity of xanthine oxidase.
if gout is detected and accompanied by increased uric acid production. Its secretion in the normal diet is 800 mg daily. Consumption of products containing less purines allows the reduction levels of uric acid down to 600 mg;
for patients with urolithiasis;
for treatment of urate nephropathy;
for elimination of urinary stones.
The patient's condition usually begins improving the day after taking Allopurinol for the first time. Its active ingredient helps reduce the concentration of uric acid in patient's serum. The recommended doses depend not only on the stones’ size.
Doctors evaluate the patient's overall renal performance. Usually, 300 mg of the drug is enough to manage the disease’s symptoms.
The drug must be taken regularly according to the doctor’s instructions. In patients with renal failure, the dose should be reduced accordingly.
Some patients experience the following side effects during treatment:
Drug interactions of Allopurinol must also be considered.
In combination with thiazide diuretics, this drug can lead to serious consequences such as:
lymphadenopathy (enlargement of lymph nodes)
alopecia (hair loss)
disorders in blood cell production
toxic hepatitis and allergic vasculitis are possible.
Uricosuric drugs allow to reduce uric acid concentrations. These drugs are prescribed to patients suffering from gout. Uricosuric drugs help patients with signs of renal hyperuricemia.
About 80% of patients were able to fully recover from the disease. The lack of positive results after the course of treatment may be associated with taking salicylates. A reduction in the therapeutic effect occurs due to the suppression of uric acid secretion. Uricosuric drugs can lead to formation of urate stones, but these cases are considered very rare. A reduction in the dose decreases the probability of stone formation.
Doctors recommend drinking more liquids for the alkalization of urine. Drug treatment may cause disorders of the digestive system and the appearance of allergic symptoms. Some patients suffer from liver necrosis and nephrotic syndrome.
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