Overproduction of uric acid can be a very bad sign of the body’s state of wellness. A problem may also arise if there would be a poor excretion of this compound. It can lead to its crystallization and deposition on the synovial fluid and other tissues leading to a disease known as gout.
It is one of the types of arthritis that is commonly caused by the foods eaten and the kidneys inability to excrete uric acid fully. Gout starts at the middle age and it is common among men. Among women, it usually appears after the menopausal age. Symptoms most likely include swelling, pain, and inflammation. There are a lot of medications available for chronic gout management as well as for acute attacks.
Gout can be considered acute if it is characterized by a rapid onset of pain, which may be classified as excruciating. There is also a presence of redness on the joint affected accompanied by swelling. Usually it starts at the metatarsophalangeal joint and commonly affects lower extremities rather than the upper one. It may resolve from a day and in worst cases it reaches ten days.
Factors that may speed its attack are surgery, trauma, acute illness, and alcohol. On the other hand, chronic gout usually affects those people with uncontrolled hyperuricemia. There would be an appearance of tophi, a crystal collection deposited in the tendons, joints, soft tissue, and bones.
Tophi may appear if a person suffered from gout for a minimum of ten years. This can cause destruction of bones that can result to crippling. This could be very alarming, thus, certain management treatments are offered to those who are suffering from this stage.
Chronic gout management often involves a long term interval treatments. Hyperuricemic therapy is initiated as a type of cure for this kind of gout. Treatment must not start during the acute attack because it can result to an increased uric acid mobilization. Some of the management remedies include these three important drugs:
1. Probenecid (Benemid). This drug increases the excretion of uric acid by the kidney resulting to decreased level in the blood. It must not be given to older persons because their renal functions are already altered. It should not also be given to those with urinary output lesser than one ml per minute, creatinine clearance lesser than 50 ml per minute, or those having renal calculi in the past. This drug increases the plasma concentrations of cephalosporin, sulphonamides, and penicillin because of its tubular secretion blockage.
2. Sulfinpyrazone. It is also a uricosuric agent that acts the same way with probenecid, which increases uric acid secretion. People using these drugs must also be careful because it can be an antiplatelet drug and can cause gastrointestinal problems such as peptic ulcer.
3. Allopurinol. It is a xanthine oxidase inhibitor that holds back the conversion of xanthine to uric acid. It is a drug of choice for those patients having impaired renal function in the past, nephrolitiasis, and those having tophaceous deposits.
Gout can be manageable. That is why during its first attack, it must be treated already to prevent tophi formation and spending a lot of money for any chronic gout management.