URIC ACID AND GOUT
GOUT AND URIC ACID
Gout is nowadays very common due to our modern purine rich foodsGout is very painfull and it is due to an increase in the levels of blood Uric Acid (Hyperuricemia) But Hyperuricemia always may not result in Gout but Gout is due to Hyperuricemia only.The reason is not well defined.
In general whenever we take proteins they would be converted in the blood as nitrogen wastes such as Urea and Creatinine and excreted by the kidneys.
Purine is a kind of Aminoacids a nitrogen compound .When we took Purine rich foods like Red Meats (Mutton,Beef,Pork etc) heavy alcoholic drinks,and chocholates the ingested purines would be coverted by an enzyme Xanthine oxidase into Uric Acid and should be excreted by the kidneys.But due to some known or unknown reasons this will not happen and eventually the uricacid levels in the blood rises to hyperglycemia.The elevated Uric Acid would react with Sodium ions to form Sodium Urate crystals which are as sharp as the broken glass pieces and deposited into joint gaps to produce gouty pain.
Gout which may be caused by idiopathic unknown reasons is known as Primary Gout.90% of the cases fall into this
Gout which may due to some pathological reasons such as Kidney diseases,Cancer is known as Secondary Gout
Primary Gout is again classified into 1.Acute Gout;2.Chronic Gout.
Treatments: ACUTE GOUT :-1.Phenylbutazone;2.Indomethacin (Indocid);3.Colchicine;4.Most of the NSAIDs except Aspirin
Aspirin should not be taken for gout as it is a weak acid weaker than uric acid and hence it would block the excretion of uric acid by kidneys.
Phenylbutazone:-This medicine is because of its serious side effects now totally out of use in humen but still use as a vetarinary medicine for horses.
Its side effects are same like that of NSAIDs such as ulcer,GI tract bleedings,Kidney Damages ,mouth ulcers etc.etc.
Indomethacin also carries the same side effects but to a lesser extent and hence can be used causiously with the advice of a Doctor.
CHRONIC GOUT :-1.Probenecid 2.Sulfinpyrazone
Both the above mentioned uricosuric agents are also weak acids similar to aspirin but at the therapeutic dosage they become stronger than uric acid and promote its excretion.Hence Doctor has to device their dosages
Allopurinol (Zyloric) is a xanthine oxidase inhibitor.This medicine is more preferable and safe.
Xanthine Oxidase is an enzyme which is converting purune into uric acid.Allopurinol act by inhibit this enzyme.
