Gout is a syndrome caused by deposition of urate crystals in the joints, leading to inflammation. The first attack of gout is usually in a single joint, most often in the foot or big toe, and the joint is typically painful, red and swollen.
Hyperuricaemia (serum uric acid concentration > 0.46 mom/l) is an important risk factor for developing gout, but many people with hyperuricaemia never develop gout. Conversely, up to 40 % of people experiencing an attack of gout have normal serum urate levels. The management of gout involves pain relief, prevention of further attacks, prevention of formation of tophi and destructive arthritis, and reducing risk factors.
These include hypertension, obesity, use of loop and thiazide diuretics, alcoholism, insulin resistance and hyperlipademia. For those who experience more than two attacks of gout per year, uric acid lowering treatment with allopurinol is recommended.
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A joint initiative of the Patient Services Section and the Drug and Therapeutics Information Service of the Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia. The RGH Pharmacy E-Bulletin is distributed in electronic format on a weekly basis, and aims to present concise, factual information on issues of current interest in therapeutics, drug safety and cost-effective use of medications.
Editor: Assoc. Prof. Chris Alderman, University of South Australia – Director of Pharmacy, RGH © Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia 5041.
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