Antigout Drugs

• Antigout Drugs: Classified as uricosuric agents, xanthine oxidase inhibitors, and anti-inflammatory agents.
• 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 of Antigout Drugs

• 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.

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