23
September
TIPS: Preventing Acute Gouty Arthritis
Prevention of attacks
- Avoid prolonged fasts and purine rich foods
- Get an ideal body weight (avoid obesity)
- Avoid alcohol excess
- Avoid very high protein meals
- No aspirin
- Long term allopurinol can be considered to reduce serum urate (not to be given until 3weeks after the attack) – allopurinol can be given 100mg daily and can increase to maximum dose of 600mg daily (side effect of allopurinol includes rash, fever and leucopenia)
- Probenecid (0.25-0.5mg twice daily) any sulfinpyrazone are the alternatives if the patient is not tolerating allopurinol
Purine rich foods:
- Offal
- Oily fish
- Roes
- Anchovies
- Mussels
- Crabs
- Prawns
- Shrimps
- Meat extract
- Yeast extract
- Spinach
- Chocolate
- Caffeine (e.g.: in cough and cold syrup)
Reference:
- Oxford handbook of clinical specialties. 5th edition. 2001.
- Harrison’s Manual of Medicine. 16th edition. 2005.
Tags: allopurinol, caffeine, gout, health, oily fish, probenicid, purine rich food, sulfinpyrazone
September 23rd, 2008 at 8:08 am
If you do get a gouty attack and can’t get to a doctor immediately, an anti inflammatory medicine, such as Advil (800mg) will help with the pain. Force fluids to help dissolve the uric acid crystals from your joints, back into your bloodstream so that it can be excreted. Ice is better than heat, and stay away from the high purine foods including shellfish, red meat and alcohol
Rich :fac13:
September 30th, 2008 at 12:28 am
Yup, you are right! However, prevention is always better than cure. If you have gout or high uric acid level in your blood (hyperuricaemia), stay away from purine rich foods.