The pain of an acute gout flare can be excruciating. Pharmacologic therapy should be started promptly; preferably within 24 hours for the most effective relief. 6 Oral corticosteroids provide relief of pain and inflammation and are a good choice for the patient with CKD. The ACR recommends prednisone mg/kg for two to five days at full dose, then tapered over seven to 10 days and stopped. Corticosteroids are not contraindicated in patients with diabetes, but blood glucose should be monitored. Adjustments to glycemic agents may be needed.
Inhibition of xanthine oxidase by some Chinese
medicinal plants used to treat gout.
J Ethnopharmacol. 2000.
The enzyme xanthine oxidase catalyses the oxidation of hypoxanthine to xanthine and then to uric acid, which plays a crucial role in gout. A total of 122 traditional Chinese medicinal plants have been evaluated for the enzyme inhibitory activity. The most active was the methanol extract of the twig of Cinnamomum cassia, which was followed immediately by those of the flower of Chrysanthemum indicum and the leaves of Lycopus europaeus. Among the water extracts, the strongest inhibition of the enzyme was observed with that of the rhizome of Polygonum cuspidatum. The study demonstrated that the effects for these medicinal plants used for the gout treatment were based, at least in part, on the xanthine oxidase inhibitory action.
Prednisone should not be taken by someone who is allergic to it or if there are fungal infections in the body. Before taking this medicine, one has to consult a doctor about his condition. Intake of prednisone is also not recommended for those who are pregnant or lactating. Prednisone either comes as a tablet, a liquid solution, or a concentrated solution to be taken by mouth. It is usually taken with food one to four times a day or as the doctor prescribes. It is very important to follow the prescription label of the drug carefully and take the medicine exactly as directed.