Gout suppressants

Gout Suppressants

Gout in the big toe

Gout suppressants are medications used to manage and prevent gout, a form of inflammatory arthritis characterized by recurrent attacks of a red, tender, hot, and swollen joint. The most commonly affected joint is the base of the big toe. Gout is caused by elevated levels of uric acid in the blood, which crystallize and deposit in joints, tendons, and surrounding tissues.

Mechanism of Action

Gout suppressants work by either reducing the production of uric acid, increasing its excretion, or reducing inflammation. The main classes of gout suppressants include xanthine oxidase inhibitors, uricosuric agents, and anti-inflammatory drugs.

Xanthine Oxidase Inhibitors

Allopurinol structure

Xanthine oxidase inhibitors, such as allopurinol and febuxostat, reduce the production of uric acid by inhibiting the enzyme xanthine oxidase. This enzyme is responsible for converting hypoxanthine and xanthine into uric acid. By inhibiting this enzyme, these medications lower uric acid levels in the blood.

Febuxostat structure

• Allopurinol: It is the most commonly used xanthine oxidase inhibitor. It is effective in reducing uric acid levels and preventing gout attacks.
• Febuxostat: An alternative to allopurinol, febuxostat is used in patients who cannot tolerate allopurinol or in whom allopurinol is ineffective.

Uricosuric Agents

Probenecid structure

Uricosuric agents, such as probenecid, increase the excretion of uric acid in the urine. They work by inhibiting the reabsorption of uric acid in the renal tubules, thus lowering blood uric acid levels.

• Probenecid: It is used in patients who under-excrete uric acid. It is often used in combination with other gout suppressants.

Anti-inflammatory Drugs

Colchicine structure

Anti-inflammatory drugs are used to manage the acute inflammation associated with gout attacks. These include nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, and corticosteroids.

• Colchicine: It is effective in reducing inflammation and pain during acute gout attacks. It works by inhibiting microtubule polymerization, which reduces the inflammatory response.
• Corticosteroids: These are used in patients who cannot tolerate NSAIDs or colchicine. They are effective in reducing inflammation and pain.

Cushing's syndrome, a potential side effect of corticosteroids

Side Effects

Gout suppressants can have various side effects. Xanthine oxidase inhibitors may cause skin rashes, liver function abnormalities, and hypersensitivity reactions. Uricosuric agents can lead to kidney stones and gastrointestinal disturbances. Anti-inflammatory drugs, particularly corticosteroids, can cause weight gain, osteoporosis, and Cushing's syndrome.

Related Pages

• Gout
• Uric acid
• Arthritis
• Xanthine oxidase
• Nonsteroidal anti-inflammatory drug