What is gout?
Once called the “disease of kings,” gout has long been associated with portly men – especially those who could afford to overindulge in rich foods and alcohol. But, in truth, gout can be a royal pain for both men and women, regardless of wealth or body size.
Gout occurs when excess uric acid, a bodily waste product circulating in the bloodstream, is deposited as needle-shaped monosodium urate crystals in tissues of the body, including the joints. For many people, the first symptom of gout is excruciating pain and swelling in the big toe – often following a trauma, such as an illness or injury. Subsequent attacks may occur off and on in other joints, primarily those of the foot and knee, before becoming chronic. In its chronic stage, gout can affect many joints, including those of the hands. Other problems related to gout can include the formation of tophi, or lumps of crystals under the skin, in the joints and in bone; kidney stones; and impaired kidney function.
Who gets gout?
Gout affects an estimated 2.1 million Americans. Men in their 40s and 50s are most likely to develop gout. But by age 60, gout affects men and women roughly equally. After age 80 more women than men have gout.
High uric acid levels (hyperuricemia), which can lead to gout, occur for one of two reasons: the body produces too much uric acid or the body is not efficient at excreting uric acid in the urine. For more than 90 percent of people with gout, the cause is the latter. There are certain inborn errors of metabolism that can cause hyperuricemia, but these genetic disorders account for a very small fraction of people with gout.
Diagnosing and treating gout
Because the joint inflammation of gout can resemble that of a joint infection or other form of arthritis, diagnosing gout requires removing a small amount of fluid with a syringe from the joint and examining it under a microscope for uric acid crystals.
When a diagnosis is made, your doctor can recommend a gout treatment plan to stop acute attacks, rapidly relieve pain and inflammation, avert future attacks and prevent the development of tophi, kidney stones and kidney disease.
Gout treatment will likely involve anti-inflammatory medications – such as corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs) and colchicine – to relieve acute pain and inflammation as well as urate-lowering drugs – such as allopurinol (Aloprim, Zyloprim) or probenecid (Benemid, Probalan) – to control urate levels and prevent future attacks.
Other gout treatment strategies include:
* Avoiding foods high in purines, such as organ meats, anchovies, shellfish, bacon and gravies, and increasing intake of dairy foods
* Avoiding alcohol, which increases the production of urate and impairs excretion
* Losing weight to reduce blood urate levels
* Avoiding medications that contribute to hyperuricemia, including diuretics
With appropriate treatment, gout is one of the most controllable forms of arthritis.
Refwww.arthritistoday.org
Attn:Treatment Mediciane
Colchicine
pronounced as(kol' chi seen)
Why is this medication prescribed?
Colchicine is used to prevent gout attacks (sudden, severe pain in one or more joints caused by abnormally high levels of a substance called uric acid in the blood) in adults, and to relieve the pain of gout attacks when they occur. Colchicine is also used to treat familial Mediterranean fever (FMF; an inborn condition that causes episodes of fever, pain, and swelling of the stomach area, lungs, and joints) in adults and children 4 years of age and older. Colchicine is not a pain reliever and cannot be used to treat pain that is not caused by gout or FMF. Colchicine is in a class of medications called anti-gout agents. It works by stopping the natural processes that cause swelling and other symptoms of gout and FMF.How should this medicine be used?
If you are taking colchicine to treat FMF, your doctor may start you on a low dose and gradually increase your dose. Your doctor may decrease your dose if you experience side effects.
If you are taking colchicine to prevent gout attacks, call your doctor right away if you experience a gout attack during your treatment. Your doctor may tell you to take an extra dose of colchicine, followed by a smaller dose one hour later. If you take extra doses of colchicine to treat a gout attack, you should not take your next scheduled dose of colchicine until at least 12 hours have passed since you took the extra doses.
Colchicine can prevent attacks of gout and control FMF only as long as you take the medication. Continue to take colchicine even if you feel well. Do not stop taking colchicine without talking to your doctor.
Other uses for this medicine
Return to topWhat special precautions should I follow?
Return to topBefore taking colchicine,
- tell your doctor and pharmacist if you are allergic to colchicine, any other medications, or any of the ingredients in colchicine tablets. Ask your doctor or pharmacist or check the medication guide for a list of ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional products, and herbal supplements you are taking, have taken within the past 14 days, or plan to take. Be sure to mention any of the following: antibiotics such as azithromycin (Zithromax), clarithromycin (Biaxin), and erythromycin (E.E.S., E-Mycin), telithromycin (Ketek), antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral); aprepitant (Emend); cholesterol-lowering medications (statins) such as atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), and simvastatin (Zocor); cyclosporine (GenGraf, Neoral, Sandimmune); digoxin (Digitek, Lanoxin); diltiazem (Cardizem, Dilacor, Tiazac, others); fibrates such as bezafibrate, fenofibrate (Antara, Lipofen), and gemfibrozil (Lopid); medications for HIV or AIDS such as amprenavir (Agenerase), atazanavir (Reyataz), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (in Kaletra, Norvir), and saquinavir (Invirase); nefazodone; ranolazine (Ranexa); and verapamil (Calan, Covera, Isoptin, Verelan). Your doctor may need to change the doses of your medications or monitor you carefully for side effects
- tell your doctor if you have or have ever had kidneyor liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking colchicine, call your doctor.
What special dietary instructions should I follow?
Return to topWhat should I do if I forget a dose?
Return to topHowever, if you are taking colchicine to treat an attack of gout that happened while you were taking colchicine to prevent gout attacks and you forget to take the second dose, take the missed dose as soon as you remember it. Then wait at least 12 hours before taking your next scheduled dose of colchicine.
What side effects can this medication cause?
Return to topColchicine may cause side effects. Tell your doctor if any of the following symptoms are severe or do not go away :
- nausea
- vomiting
- diarrhea
- stomach cramps or pain
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:
- muscle pain or weakness
- numbness in the fingers or toes
- unusual bruising or bleeding
- sore throat, fever, chills, and other signs of infection
- weakness or tiredness
- paleness or grayness of the lips, tongue, or palms
What storage conditions are needed for this medicine?
Return to topIn case of emergency/overdose
Return to topSymptoms of overdose may include:
- stomach pain
- nausea
- vomiting
- diarrhea
- unusual bruising or bleeding
- sore throat, fever, chills, and other signs of infection
- paleness or grayness of the lips, tongue, or palms
- slowed breathing
- slowed or stopped heartbeat
What other information should I know?
Return to topDo not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
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