This drug can be administered orally or parenterally, to treat gout and prevent the recurrence of kidney stones. Allopurinol treatment is the mainstay in the prophylaxis of hyperuricemia in patients receiving chemotherapy [ 20 ].
Full Answer
Is there a role for hyperuricemia in the management of gout?
Despite being the most common type of inflammatory arthritis, gout is often poorly managed. Except for febuxostat and pegloticase, research in new therapeutic agents for the management of hyperuricemia in gout remained insufficient for several decades. With emerging evidence of possible roles of hyp …
Is there a new treatment for hyperuricemia?
Therefore, medical treatment of hyperuricemia has regained interest in recent years, in particular since after decades of therapeutic stagnation, new treatments of hyperuricemia have been approved or are currently being investigated in clinical trials.
What is the PMID for hyperuricemia and gout?
PMID: 31446403 Diagnosis and treatment for hyperuricemia and gout: a systematic review of clinical practice guidelines and consensus statements
What is the pathophysiology of hyperuricemia?
Alongside with an inflammatory state triggered by urate crystal deposition in the joints, hyperuricemia displayed additional pathophysiological consequences leading to tissue inflammation mainly in the vascular wall. Thus, therapeutic strategies used to treat hyperuricemia in the past decades have often been focused on limiting acute episodes.
Which drug is used in the treatment of hyperuricemia and gout?
Allopurinol (Zyloprim, Prometheus), a potent purine xanthine oxidase (XO) inhibitor, is the most commonly used drug in the treatment of hyperuricemia. Until recently, it was the only available inhibitor of uric acid synthesis.
What is the goal with allopurinol therapy in the treatment of hyperuricemia in gout patients?
Allopurinol (Aloprim, Zyloprim): Allopurinol should be initiated at 100 mg daily to minimize the risk of ULT-induced gout flare and the threat of allopurinol hypersensitivity. It should be titrated by 50 to 100 mg every 2 to 5 weeks to the dose required to achieve goal serum urate levels.
What does the drug allopurinol used for gout have to do with the enzymes?
Allopurinol decreases blood and urine uric acid levels by blocking xanthine oxidase. This is an enzyme that helps make uric acid. High levels of uric acid in your blood or urine can cause gout or kidney stones.
Which pharmacological effects are used to prevent hyperuricemia for a client with gout?
Treatment of gout involves managing hyperuricemia with urate-lowering therapy (i.e., diet, lifestyle, pharmacologic agents) and of acute gouty arthritis with colchicine, nonsteroidal anti-inflammatory drugs, and/or corticosteroids.
When should hyperuricemia be treated?
To prevent gouty arthritis, cardiovascular disease, and renal failure, the Japanese guidelines for management of hyperuricemia and gout recommends initiating pharmacologic urate-lowering therapy for asymptomatic hyperuricemia when serum urate levels increase to > 8.0 mg/dL [3].
What is hyperuricemia and gout?
Hyperuricemia occurs when there's too much uric acid in your blood. High uric acid levels can lead to several diseases, including a painful type of arthritis called gout. Elevated uric acid levels are also associated with health conditions such as heart disease, diabetes, and kidney disease.
What is the purpose of allopurinol?
Allopurinol is used to prevent or lower high uric acid levels in the blood. It is also used to prevent or lower excess uric acid levels caused by cancer medicines or in patients with kidney stones. A high uric acid level can cause gout or gouty arthritis (joint pain and inflammation).
Why does allopurinol worsen acute gout?
The most common adverse effect of allopurinol is the precipitation of an acute flare of gout. This is due to urate lowering resulting in urate crystals being shed from articular cartilage into the joint space, resulting in acute inflammation.
Why allopurinol is contraindicated in acute gout?
Allopurinol should not be stopped during acute flares of gout. Stopping allopurinol during an acute flare means therapeutic effect is lost and the urate level will rise. In addition, there is a real risk of the allopurinol not being recommenced as well as precipitating another flare when it is recommenced.
What causes hyperuricemia?
Hyperuricemia can occur as a result of your body producing too much uric acid or getting rid of too little. You have a purine-rich diet. Foods high in purine include some organ meats, game, herrings and a few other types of seafood, and beer. Your body's cells break down due to exercise and certain other conditions.
How do you prevent hyperuricemia?
Read on to learn how you can lower uric acid levels in your body naturally.Limit purine-rich foods. You can limit the source of uric acid in your diet. ... Avoid sugar. Sugary foods. ... Avoid alcohol. ... Lose weight. ... Balance insulin levels. ... Add more fiber to your diet. ... Reduce stress. ... Check your medications and supplements.More items...
How does colchicine work for gout?
For gout, colchicine works by reducing the inflammation caused by crystals of uric acid in your joints. This also helps to reduce pain. The way that colchicine works for familial Mediterranean fever (FMF) is complicated. Colchicine can affect the way your white blood cells work.
What is hyperuricemia?
Hyperuricemia is precisely as you may imagine. It is a condition in which uric acid levels will be extremely high and they can reach various values all above 7 mg/dl in the blood.
Hyperuricemia and gout connection
By now, you should know that gout and hyperuricemia are connected and that they are not the same thing. Gout is a symptom of hyperuricemia and it occurs only in 20% of people suffering from the condition.
Treatment for the hyperuricemia
I had to devote a major section here to the treatment of patients who suffer from gout and hyperuricemia. First of all, if you suffer from asymptomatic hyperuricemia there is no treatment available nor one is recommended. What this means that there are no benefits and advantages of therapies that can lower uric acid levels.
Conclusion
In the end, all I can say about gout and hyperuricemia is that gout occurs as a side effect of the main condition and you need to treat it separately. Hyperuricemia isn’t treated as a separate disease simply because it is a condition, not a disease. Treating gout is something I can help you with, so read my posts.