Antigout Drugs (Drugs for Gout)
Gout is a metabolic disorder characterized by hyperuricaemia (normal plasma urate 1-4 mg/ dl).
1. Drugs for acute gout
Acute gout manifests as sudden onset of severe inflammation in a small joint (commonest is metatarso-phalangeal joint of great toe) due to precipitation of urate crystals in the joint space.
- One of the strong anti-inflammatory drugs is given in relatively high and quickly repeated doses.
- They are quite effective in terminating the attack, but may take 12-24 hours, i.e. response is somewhat slower than with colchicine, but they are generally better tolerated; majority of patients prefer them over colchicine.
- Their strong anti-inflammatory (not uricosuric) action is responsible for the benefit.
- Colchicine is neither analgesic nor antiinflammatory, but it specifically suppresses gouty inflammation.
- It does not inhibit the synthesis or promote the excretion of uric acid. Thus, it has no effect on blood uric acid levels.
- Intra-articular injection of a soluble steroid suppresses symptoms of acute gout.
- Crystalline preparation should not be used.
- It is indicated infractory cases and those not tolerating NSAIDs/Colchicine.
2. Drugs for chronic gout or hyperuraecemia
When pain and stiffness persist in a joint between attacks, gout has become chronic.