The pain during a gout attack, all patients who have experienced it have a discoloration, and even use a “knife” , “needle” to describe. When gout attacks, the patient must have only one wish, that is, “quick pain relief”. How to properly use anti-inflammatory analgesics during an acute gout attack?
01
Manifestations of acute goutThe acute symptoms of gout are redness, swelling, heat, and pain in the joints, and even headache and fever.
02
Gout Causes of Attack
High uric acid causes gout Attacks, drinking, overeating, cold, fatigue, infection, etc. are all important incentives for gout attacks. If you eat high-purine foods while drinking, it will lead to a rapid increase in blood uric acid, resulting in an acute attack of gout.
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How to choose pain medication?
The principle of acute treatment is to quickly control the joint Symptoms and pain of inflammation. Drugs to control acute inflammation are best started within 24 hours of onset. There are three types of drugs commonly used in acute exacerbations: colchicine, non-steroidal anti-inflammatory drugs (such as ibuprofen), and glucocorticoids (such as prednisone). The first-line treatment drugs include colchicine and non-steroidal anti-inflammatory drugs. When there are contraindications to treatment or the treatment effect is not good, short-term anti-inflammatory treatment with glucocorticoids can also be considered.
04
NSAID Dosage and Choice
Also known as painkillers, the scientific name is NSAIDs. Inflammatory drugs are recommended.
1. NSAIDs are divided into
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Non-selective cyclooxygenase inhibitors: ibuprofen, naproxen Health and so on. Selective cyclooxygenase 2 inhibitors: celecoxib, etoricoxib, etc.
2. The principle of pain relief< /span>
By inhibiting the activity of cyclooxygenase in the human body, thereby inhibiting the inflammatory response and achieving the effect of pain relief, the two types of non-steroidal anti-inflammatory drugs have their own advantages and disadvantages. 3. Drug selection
Non-selective cyclooxygenase inhibition There is a greater risk of peptic ulcers or bleeding. Therefore, if you have a history of peptic ulcer and are older than 65 years, a selective cyclooxygenase 2 inhibitor (eg etoricoxib) is recommended. Selective cyclooxygenase 2 inhibitors have a slightly higher risk of myocardial infarction and stroke. Therefore, it should be used with caution in patients with obvious cardiovascular risk factors (hypertension, hyperlipidemia, diabetes, smoking).
05
Colchicine
Colchicine is an anti-inflammatory and analgesic. It is the first-line drug for acute gout attacks, but it is ineffective for other causes of joint pain. . It does not affect the formation, dissolution and excretion of urate, so it has no effect of lowering blood uric acid.
It is best to start the drug within 12 hours of acute gout attack, and the efficacy will decrease significantly after 36 hours. Usually, colchicine takes effect 12 to 24 hours after oral administration, and 90% of patients have pain relief within 24 to 48 hours of taking the drug, and the effect lasts for 48 to 72 hours.
The effective therapeutic dose of colchicine is very close to the toxic dose, and gastrointestinal symptoms such as nausea, vomiting, diarrhea, and abdominal pain are actually mild poisoning, and the drug should be discontinued immediately.
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Glucocorticoids
It is the hormone we often say (such as prednisone), it is not preferred to use, only when the above two types of drugs are ineffective, or the kidney function is not good and cannot use the above drugs. .
Long-term use of hormones can cause side effects such as central obesity, diabetes, osteoporosis, gastric mucosal damage, infection, etc., but short-term use, such as 1 week, is generally safer.
At present, drugs are still a faster and more effective way to relieve joint symptoms during acute gout attacks, but they should be carried out under the guidance of doctors.It is necessary to actively control the blood uric acid level, reduce the number of acute gout attacks, and control the disease as a whole.
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