What medicine should be taken for tophi to excrete uric acid?
In recent years, the incidence of gout has increased year by year, becoming a health problem that plagues many people. Tophi is a typical manifestation of late-stage gout, formed due to long-term deposition of uric acid in joints and surrounding tissues. How to effectively discharge uric acid and relieve the symptoms of tophi through drugs has become one of the issues that patients are most concerned about. This article will combine the hot topics and hot content on the Internet in the past 10 days to introduce you to relevant drugs and treatment options in detail.
1. The causes and harm of tophi
Tophi are nodules formed by the deposition of uric acid crystals in joints, soft tissues, etc. due to long-term high blood uric acid levels. Commonly found in auricles, fingers, elbows and other parts of the body. Tophi not only affects the appearance, but may also cause joint deformity, limited mobility, and even damage to kidney function.
2. List of commonly used drugs for uric acid excretion
| drug type | Representative medicine | Mechanism of action | Applicable people |
|---|---|---|---|
| Inhibit uric acid production | Allopurinol, Febuxostat | Inhibit xanthine oxidase and reduce uric acid production | uric acid overproduction type |
| Promote uric acid excretion | Benzbromarone, probenecid | Inhibits renal tubular reabsorption of uric acid | Poor uric acid excretion type |
| Uricase preparation | rasburicase | Break down uric acid into soluble substances | severe hyperuricemia |
| auxiliary medication | sodium bicarbonate | Alkalinize urine and promote dissolution of uric acid | Patients with uric acid kidney stones |
3. Precautions for drug selection
1.Select drugs based on uric acid metabolism type: It is recommended to conduct a 24-hour uric acid excretion measurement first to determine whether it is an overproduction or underexcretion type.
2.Kidney function considerations: Patients with renal insufficiency need to adjust the dosage. Patients with severe renal insufficiency should use benzbromarone with caution.
3.drug interactions: The combination of allopurinol with azathioprine and mercaptopurine will increase toxicity; the combination of benzbromarone and warfarin may enhance the anticoagulant effect.
4.Adverse reaction monitoring: Allopurinol may cause allergic reactions; febuxostat requires caution for cardiovascular risks; benzbromarone may cause abnormal liver function.
4. Latest research progress
Research hot spots on gout treatment at home and abroad in the past 10 days include:
| Research areas | Latest findings | clinical significance |
|---|---|---|
| gene therapy | New uric acid transport target discovered | Provide direction for the development of new uric acid-lowering drugs |
| drug combination | Allopurinol + Benzbromarone Synergy | Better effect on mixed hyperuricemia |
| Traditional Chinese Medicine Research | Some traditional Chinese medicine ingredients have the effect of promoting uric acid excretion | Provide basis for integrated traditional Chinese and Western medicine treatment |
5. Auxiliary measures other than drug treatment
1.Diet control: Limit the intake of high-purine foods, such as animal offal, seafood, etc.; increase the intake of low-fat dairy products and vegetables.
2.Drink more water: Daily drinking water should reach 2000-3000ml to promote uric acid excretion.
3.moderate exercise: Avoid strenuous exercise-induced gout attacks, and recommend low-impact exercises such as swimming and cycling.
4.weight management: Weight loss in obese patients can help reduce blood uric acid levels.
6. Frequently Asked Questions
Q: Is surgery necessary for tophi?
A: Not all tophi require surgery. Tophi that are small in size and do not affect function can be dissolved with drugs; surgery is recommended for tophi that are large in size and affect joint function or are repeatedly infected.
Q: Do uric acid-lowering drugs need to be taken for life?
A: Most patients require long-term maintenance treatment. When the blood uric acid reaches the target (<300 μmol/L) and the tophi is completely dissolved, you can try to gradually reduce the dosage under the guidance of a doctor.
Q: What should I do if gout attacks while taking medication?
A: This is a normal phenomenon and is called "crystal melting pain". You can continue to take uric acid-lowering drugs, and add colchicine or NSAIDs to control symptoms. Do not stop taking the drug without authorization.
Summary: The treatment of tophi requires long-term standardized uric acid-lowering drug treatment. Drug selection should be individualized and combined with lifestyle adjustments. It is recommended to regularly monitor blood uric acid levels and liver and kidney functions, and adjust the treatment plan under the guidance of a rheumatologist to achieve the best treatment effect.
check the details
check the details
en
