Joint pain caused by gout is often excruciating. However, many people forget about the pain after the pain, and do not go to the hospital for further examination and treatment in time. Many people think that the only treatment for gout is painkillers, but in addition to pain relief, the more important treatment for gout is uric acid reduction therapy during the remission period. A number of gout medications have been introduced before, so today, let’s review them again in general. Gout treatment medications include both pain medications for acute attacks and uric acid-lowering medications for remission. Gout treatment does not only rely on drugs, but also requires patients to control their diet in a non-pharmacological way, which requires some self-discipline from patients.
I. Drug treatment
Drugs to control acute attacks
1.Non-steroidal anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs in the clinical use of more, the effect is also very good, but can not be used in large quantities for a long time.
Traditional NSAIDs (such as indomethacin, ibuprofen, etc.) have more side effects and may cause serious gastrointestinal bleeding, so it is recommended to take them after meals, and if symptoms of stomach discomfort occur you can add some stomach protection drugs at the same time. Celecoxib and etoricoxib are new NSAIDs that are more commonly used, with good efficacy and few side effects, but they are not suitable for patients with combined cardiovascular disease.
2.Colchicine
Colchicine is the “most familiar stranger” to gout patients, and many patients refuse to use colchicine because they are afraid of its side effects.
Nowadays, colchicine is no longer taken orally in large doses as in the past, but in small doses, which greatly reduces the side effects and has the same efficacy.
In addition, colchicine is now also mostly used for preventive use during the remission phase of gout.
It is believed that many gout patients also have gout attacks in the process of lowering uric acid. It is not that lowering uric acid is ineffective, but that gout attacks caused by fluctuations in uric acid levels in the body can be prevented by using colchicine in small doses at the same time.
3.Glucocorticoid
Only when the above two drugs cannot be used or are ineffective, doctors will consider choosing hormones. The use of hormones must be done under the guidance of a regular hospital physician.
Drugs for lowering uric acid
Uric acid-lowering drugs are divided into two main categories.
1.Inhibit uric acid synthesis
These include allopurinol and the new xanthine oxidase inhibitors (febuxostat).
2.Promote uric acid excretion
Mainly includes propoxur, benzbromarone, sulfopiridone.
The above two types of drugs have different mechanisms of action and are not absolutely superior or inferior. It is recommended that the most appropriate drug can be selected by clinicians according to the comprehensive situation of individuals.
It should be noted that drugs that promote uric acid excretion are not suitable for patients with kidney stones, as they can increase the burden on the kidneys.
Medications to alkalize urine
The main one is sodium bicarbonate or sodium potassium bicarbonate. Sodium bicarbonate is what we usually call “baking soda”.
Higher urine pH (i.e., more alkaline) may increase the risk of calcium-related stones.
Urine pH below 6.0: need to alkalize the urine.
Urine pH between 6.2 and 6.9: facilitates dissolution and elimination of urate crystals from the urine.
Urine pH > 7.0 is prone to the formation of calcium oxalate and other types of stones.
Therefore, it is important to review the pH of urine regularly when taking such drugs to adjust the medication and reduce the risk of urinary stones.
Non-pharmaceutical treatment
1.Control diet: Try to control your diet and eat less food with high purine content, such as crabs, pork liver, soybeans, etc., and focus on food with low purine content, such as rice, noodles, milk, eggs, etc.
2.More exercise: do more aerobic exercises with moderate intensity, such as jogging, brisk walking, etc.
3.Drink more water: drink 2000-3000ml of water every day to help excretion of uric acid.
4, weight control: for overweight patients, gradual weight loss can effectively prevent gout.
Each drug has corresponding indications and contraindications, and there is no special drug for the treatment of gout. Be sure to visit a specialist at a regular hospital and have a professional physician make a judgment based on the comprehensive situation.
Sometimes, if one medication does not bring the blood uric acid under control, then the doctor may consider combining several medications. Gout patients must watch for possible side effects while taking medication. Long-term adherence to non-pharmacological treatment is also important in the treatment of gout and requires a high degree of self-discipline on the part of the patient.