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Symptoms and treatments for Gout

Symptoms and treatments for Gout. Beverly Hardy. What is Gout?. A condition where there is a vast accumulation of uric acid onto the joints Leads to the formation of monosodium urate in various tissues in the body The amount of uric acid needed to cause Gout is above 360 m mol/L. Symptoms.

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Symptoms and treatments for Gout

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  1. Symptoms and treatments for Gout Beverly Hardy

  2. What is Gout? • A condition where there is a vast accumulation of uric acid onto the joints • Leads to the formation of monosodium urate in various tissues in the body • The amount of uric acid needed to cause Gout is above 360mmol/L

  3. Symptoms • The main symptoms of Gout are • Pain in joints areas • Swelling of joint areas

  4. Cause of symptoms • When monosodium crystals gets into joints, this illicit a reaction from the body’s immune system • The body macrophages and neutrophils attack the monosodium urate crystals causing inflammation of the joint.

  5. Treatments • There are many treatments for gout • Some are used for treating the symptoms of gout, while others are used to stop gout symptoms from appearing. • Because Gout is a metabolic condition, there is no cure for it.

  6. NSAIDS • Acute treatment for gout is using NSAIDs • Used to alleviate the pain caused by inflammation • Side-effects • Nausea • Vomiting • In extreme cases, kidney failure

  7. Colchicine or (N-​[(7S)-​1,​2,​3,​10-​tetramethoxy-​9-​oxo-​5,​6,​7,​9-​tetrahydrobenzo​[a]​heptalen-​7-​yl]​acetamide) • Oldest drug used for gout flares • Alkaloid • Prophalytic • Dosage: 0.5g 3 times daily

  8. Colchicine (cont’d) • Acts on tubulin • Interferes with microtubule formation in neutrophils • Causes low amount of neutrophils to be made, decreasing inflammation.

  9. Allopurinol or 1,5-dihydro-4H-pyrazolo[3,4-d]pyrimidin-4-one • Used as along term treatment for gout • Lowers uric acid levels • Isomer of hypoxanthine • Is a xanthine oxidase inhibitor • Dosage:100mg per day

  10. Allopurinol (cont’d) • Xanthine oxidase catalyzes the final reaction of the purine catabolic pathway that makes uric acid. • Allopurinol bind to xanthine oxidase and limits its activity.

  11. Benzbromarone • Xanthine oxidase inhibitor • Benzofuranderivative • Sometimes used in conjunction with Allopurinol • Side effects • Nausae • Very hepatotoxic

  12. Possible treatments • Febuxostat • Xanthine oxidase inhibitor • Can work in people with renal failure • Higher cost • Recombinant uratoxidase • Degrade urate into allantion • Not in use yet for Gout

  13. Possible treatments • If all else fails • Surgery may be need to remove uric acid build up

  14. Questions?

  15. Literature Cited • Nuki, G., and Simkin, P. A. (2006) A concise history of gout and hyperuricemia and their treatment, Arthritis Res Ther8 Suppl 1, S1. • WebMD. (2010) Arthritis and Gout. • Busso, N., and So, A. (2010) Mechanisms of inflammation in gout, Arthritis Res Ther12, 206. • Chia, E. W., Grainger, R., and Harper, J. L. (2008) Colchicine suppresses neutrophil superoxide production in a murine model of gouty arthritis: a rationale for use of low-dose colchicine, Br J Pharmacol153, 1288-1295. • Conaghan, P. G., and Day, R. O. (1994) Risks and benefits of drugs used in the management and prevention of gout, Drug Saf11, 252-258. • Voet, D., Voet, J. G., and Pratt, C. W. (2008) Fundamentals of biochemistry : life at the molecular level, 3rd ed., Wiley, Hoboken, NJ. • Pacher, P., Nivorozhkin, A., and Szabo, C. (2006) Therapeutic effects of xanthine oxidase inhibitors: renaissance half a century after the discovery of allopurinol, Pharmacol Rev58, 87-114. • Tausche, Anne-Kathrin, Tim L. Janse, Hans-Egbert Schröder, Stefan R. Bornstein, Martin Aringer, and Ulf Müller-Ladner. "Gout—Current Diagnosis and Treatment." DtschArzteblInt 106 (2009): 549-55. PMC. NCBI, 24 Aug. 2009. Web. 16 Nov. 2012. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2754667/ • Heel, RC, RN Brogden, TN Speigth, and GS Avery. "Benzbromarone: A Review of Its Pharmacological Properties and Therapeutic Use in Gout and Hyperuricaemia." Drugs14.5 (1977): 329-66. PubMed. NCBI. Web. 16 Nov. 2012. <http://www.ncbi.nlm.nih.gov/pubmed/338280>.

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