Gout Symptoms Cures
Intercritical Gout:
There is a Gout symptom free period after the first attack. Eventually this phase is interrupted by the recurrence of acute attacks.
Onset of attacks:
The second attack usually occurs within one year from the first, although it may be delayed for 5-10 years.
Treatment:
Prevent by identifying and correcting the cause of increased uric acid OR by administering drugs that inhibit the synthesis of urate or increase its excretion.
Low dose NSAIDS as mentioned before may be effective but carries a higher risk of side effects.
Uricosurics – Probenecid and Sulfinpyrazole are preferred for underexcreters. These meds work by blocking the reuptake of urate by the kidneys therefore it is easily excreted. Probenecid is given initially in two oral doses of 250 mg for 1 week, and then increased to 500 mg twice daily every 1-2 weeks until serum uric acid level drops < 6 mg/dL (titrate to 1.5 g/day). Sulfinpyrazole is given initially in two daily doses of 50 mg, then increased by 100 mg weekly (titrate to 200 mg/day).
Xanthine oxidase inhibitor – Allopurinol blocks the final step in uric acid synthesis. It may be used for both underexcreters and overproducers. Allopurinol is given initially in a daily dose of 100-300mg/day, and then increased in weekly increments if needed. The main adverse effect is a rash which usually subsides with a lower dose.
Other drugs that increase uric acid excretion:
Losartan (Cozaar) – this is a good choice if patient is also hypertensive. This agent lowers serum uric acid levels by blocking its reuptake by the kidneys, therefore it is more easily excreted.
Fenofibrate (Tricor) – this is a good choice if patient also has high triglycerides. This agent lowers uric acid levels by increasing renal clearance.
Febuxostat is an investigational drug which is an alternative to Allopurinol. It works the same way although it may be more effective agains gout symptoms.
Gout Symptoms:
This may occur if gout and hyperuricemia go untreated for many years.
The constant increased levels of uric acid lead to development of tophi in the synovial, olecranon bursae, and other periarticular locations.
Eventually the cartilage may be destroyed and the joint may become deformed.
Allopurinol and Probenecid may be given in combo to treat severe situations.
The treatments for gout symptoms unfortunately are not normally used in senior citizens because of the increased risk of GI ulcers and cardiovascular effects….Although in the case of Gout Symptoms the benefit of treatment outweighs the risk.
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