Gout is a form of inflammatory arthritis characterized by hyperuricemia and deposition of monosodium urate crystals in joints.
Antigout drugs are aimed at reducing uric acid levels and managing acute attacks.
Classes of Anti-Gout Drugs
1) Drugs for acute gout:
NSAIDs (e.g., Indomethacin, Naproxen) – first-line for acute pain and inflammation.
Colchicine: Binds to tubulin, inhibits leukocyte migration and phagocytosis → reduces inflammatory response to urate crystals.
Glucocorticoids (e.g., Prednisolone) – used if NSAIDs/Colchicine are contraindicated.
2) Drugs for chronic gout (urate-lowering therapy):
Xanthine Oxidase Inhibitors (e.g., Allopurinol, Febuxostat) – decrease uric acid production.
Uricosurics (e.g., Probenecid) – increase uric acid excretion by inhibiting tubular reabsorption.
Uricases (e.g., Pegloticase) – converts uric acid to allantoin (more soluble, easily excreted).
Lifestyle and Dietary Modifications
Dietary Changes: Avoid purine-rich foods (e.g., red meat, seafood), alcohol, and high-fructose corn syrup.
Hydration: Increase fluid intake.
Weight Management: Maintain healthy weight to lower uric acid.
Prevention of Gout Flares During Therapy Initiation
Prophylaxis: Low-dose colchicine or NSAIDs during urate-lowering therapy initiation.
Rationale: Prevents flares caused by mobilization of urate deposits.