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Gouty Arthritis Part II: Medical Management

Gouty tophus of the knee.

In all likelihood, the diagnosis of gout means treatment with medication will be involved.  In this post, we'll look at some of the medications used to treat gout and how they work.  Part III of this series will
focus on non-drug measures to help relieve the pain of gout and prevent recurrent attacks.

Pharmaceutical treatment of gout falls into two basic categories: the first category consists of medications that would be used for a gouty attack, while the second category of drugs are utilized to help prevent future attacks.

Drugs for treatment of gout attacks are agents that help to reduce the pain and inflammation associated with the condition.  Many years ago, the primary agents for gout attack were butazolidin (one of the first NSAIDs on the market) and colchicine.  Butazolidin was removed from the US market many years ago over safety concerns, and has largely been replaced by more modern day agents such as ibuprofen or naproxen.  Colchicine is still in use--but usually only for those who do not tolerate NSAIDs.  If a patient cannot tolerate either NSAIDs or colchicine, steroids such as prednisone or an injectable corticosteroid can be utilized.

Once the diagnosis of gouty arthritis is confirmed, and the acute attack is under management, efforts to prevent future recurrences come into play.  The two most common drugs for this purpose are allopurinol and febuxostat.  While allopurinol is the older of these two products; they are both used to limit the body's production of uric acid. This in turn helps to lower uric acid levels and reduce the risk of future attacks. 

Sources: Wikimedia, MayoClinic,Pixabay


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