50-year-old Mr. Wang is the leader of a clothing company. Because he often needs social engagements, he often drinks with big fish and meat. was found to have high uric acid and mild renal abnormalities very early. The doctor prescribed him benbromalon and told him to take regularly and regularly, and drink more water and urinate more.
1 weeks ago, Mr. Wang drank a lot of alcohol for socializing, and in the middle of the night, he found severe pain in the big toe on his left foot, accompanied by obvious redness and swelling. He knew it was gout, , but there was a very important meeting the next day, so he did not go to the hospital immediately, but took some pain medication and benbromalon, thinking that he could control his symptoms for the time being, but the pain became even more severe the next day, and the entire face of his right foot was swollen , so he did not dare to delay and hurried to the hospital.
After coming to the hospital, the doctor After listening to Mr. Wang's description, he told him not to use benzenebromalone and increased the dose of painkillers. After the redness and pain in Mr. Wang's right foot improved, the doctor added benzenebromalone and told him to drink more water and urinate more . Mr. Wang was very confused. Didn't he say benzenebromalone lower uric acid? Why does gout worsen? The doctor explained that the main function of benbromaron is to strengthen the kidneys' excretion of uric acid, but it cannot be used in the acute phase of gout, otherwise it will stress-aggregate urate crystals deposited on the joints and aggravate gout. However, after the acute phase, benbromaron can accelerate uric acid excretion, so it is important to accurately grasp the time of taking . The doctor told Mr. Wang to take benbromalon regularly after being discharged from the hospital and to ban alcohol. Mr. Wang agreed.
1. How does gout occur?
gout, also clinically known as gout arthritis , is a common metabolic disease. The key mechanism of 's disease lies in the synovial membrane, bursal , cartilage and other joint structures, which induce and relieve acute inflammation and destroy joint structure . It is more common in small joints, such as the big toe joint, the big thumb joint, the ankle joint, etc., but occasionally it can occur in large joints such as knee joint , shoulder joints.
The main clinical practice is gouty arthritis, which is manifested as sudden joint swelling and pain, which may be accompanied by redness in the skin. Long-term gouty arthritis may even induce joint deformities, resulting in loss of joint activity. Secondly, patients with gout are often accompanied by hyperuricemia, which is an important cause of inducing stones. For example, kidney stones , urinary tract stones, etc. are mostly related to high uric acid levels. Therefore, it is very important to recognize the pathogenesis of gout in a timely manner and scientific prevention and treatment of gout.
The main mechanisms for inducing gouty arthritis in clinical practice are as follows.
1. Intake of purine in a short time, purine excessive
purine is one of the components of the constituent cells. Therefore, the human body needs to supplement purine every day to meet the needs. Uric acid is the final product of purine metabolism. Under normal circumstances, these uric acids will be excreted through the kidneys. However, if excessive high purine substances such as wine, fish, shrimps, etc. are consumed in a short time, it will lead to a large amount of uric acid in the human body in a short time, exceeding the normal excretion level of the kidneys. These uric acids that cannot be excreted in time will form crystals and deposited into tissues and organs, induced gout, stones and other diseases.
2, abnormal purine metabolism
Human body Purine metabolism is mainly carried out in cells. Under the action of various biological enzymes purine will be converted into uric acid and enter the blood, and then excreted through the kidneys. , but the deficiency of certain specific enzymes Depth can cause an increase in uric acid, such as PRPP synthase, HGPRT enzyme, 6-phosphor glucose, etc. Due to the lack of these enzymes in the human body, the body loses control over purine metabolism, resulting in a large amount of uric acid production in a short period of time. In clinical practice, people like often show refractory hyperuricemia, and even gout once they drink alcohol, or eat more fish and shrimp and other high-purine foods, they will induce gout .
3, Uric acid excretion disorder
The kidney is the main organ that excretes uric acid. It is worth mentioning that the kidney not only excretes uric acid, but also reabsorbs a part of the uric acid into the blood to maintain the uric acid level in the body. However, once the kidney function is abnormal, it is easy to lead to reduced uric acid excretion or increased reabsorption, which induces gout , the most common of which is the drug Factors, , such as diuretics , aspirin, antibiotics, etc., , these drugs will inhibit the kidney's excretion of uric acid, or enhance the reabsorption of the kidney, leading to an increase in uric acid level; secondly, Some chronic kidney disease , urinary stones, etc. will directly damage the kidney's function , resulting in the weakening of the kidney's excretion capacity, and a large amount of uric acid is retained in the body, thereby inducing gout.
2. The mechanism and characteristics of benzofuran
benzofuran is a derivative of benzofuran and is a first-line drug for the clinical treatment of intermittent periods of hyperuricemia and gouty arthritis. The main mechanism of action of is to inhibit the reabsorption of uric acid by the kidney, thereby increasing the excretion of uric acid and reducing the blood uric acid level. Many studies have shown that benzofuran can not only reduce uric acid, but also prevent gout. , but it has certain requirements for kidney function, so not all gout patients can take .
Uric acid is one of the substances that maintain acid-base balance in the human body. Therefore, not all uric acid needs to be excreted from the body. Instead, the kidney needs to reabsorb part of the blood from the original urine to maintain the pH of the human body . The distal concave tubules of the kidney are the main part of the body that absorbs uric acid. They have protein channels that specialize in transporting uric acid, which can re-suck part of the uric acid in the original urine into the blood. benbromaron can be combined with these protein channels to produce a competitive effect with uric acid, rapidly reducing the reabsorption of uric acid by the distal traverse tubules and increasing uric acid excretion. Therefore, those who cause excessive uric acid due to abnormal renal excretion, benbromaron is particularly suitable for .
Secondly, benzylbromalone has a certain anti-inflammatory effect, which can reduce the damage of inflammatory reactions to the kidneys, long-term tubules and other structures, and protect the kidney function . Studies have found that benzylbromaron can effectively inhibit the production of various inflammatory factors, reduce inflammatory responses, protect tissue structures, and especially have a certain protective effect on kidney structure.
3. Why can’t be taken benbromalon in the acute stage of gout?
Clinically, a patient took benbromalon in the acute phase of gout. The results showed that not only did not relieve the symptoms, but also significantly worsened. Why is this? is actually related to the characteristics of uric acid metabolism in the human body, and also to the characteristics of the effect of benbromalon. In short, benbromalon cannot be used in the acute phase of gout, but can only be used in the remission or intermittent phase .
There are about 1200 mg of uric acid in the body of normal adults, and every time about 600 mg of uric acid is produced, 600 mg of uric acid will be excreted at the same time, and then it is in a equilibrium state. However, once the uric acid level in the human body suddenly decreases, or huge fluctuations occur, it will induce the body's own stress reaction, promote the formation of uric acid in the human body, and deposit it in joints or organs, achieving the purpose of reducing uric acid excretion . Gout patients often have a long-term high uric acid level, Therefore, if you take benzylbromaron in acute condition, it will cause a sharp drop in the uric acid level, which will stimulate the body's self-regulation function and increase the deposition of uric acid crystals in the joints. Not only will it not relieve the condition, but it will easily aggravate the symptoms of gout .
Secondly, Benzenebromalone itself takes effect very quickly, and it can exert its efficacy in about 2 hours. It reduces the reabsorption of uric acid by the kidney in a short period of time and accelerates the excretion of uric acid. Because patients with acute gout often induce a rapid drop in the blood uric acid level in a short period of time, leading to a stress response. It is necessary to not take it in acute gout. It is recommended that patients with gout take colchicine or non-steroidal anti-inflammatory drugs in the acute phase, and wait for the gout symptoms to stabilize and the joint pain to significantly relieve before taking benzebromalone .
4. The following three diseases can be treated in clinical practice.
. Clinically, benzylbromaron is a common drug for the treatment of hyperuricemia and the prevention and treatment of gout and other diseases. However, the dosage and method of benzylbromaron are different when treating different diseases. Therefore, individualized medication plans should be paid attention to. It is recommended that patients in need take medication under the guidance of a doctor. Clinically, benzylbromaron is often used to treat the following three diseases.
1, symptomatic or asymptomatic hyperuricemia
Clinical hyperuricemia patients can be divided into symptomatic and asymptomatic two types. Among them, symptomatic patients mostly manifest as muscle and joint pain, or abnormal renal function, but most hyperuricemia patients are asymptomatic patients. Except for the high uric acid level, there is no obvious discomfort. Clinical studies have shown that benzene bromron has good therapeutic effects for patients with symptomatic or asymptomatic hyperuricemia. Standardized use of benzene bromron can effectively reduce blood uric acid levels and alleviate various clinical symptoms . In most cases, patients with hyperuricemia do not need to take benbromalon orally for a long time, , but if the patient is accompanied by renal abnormalities or lacks biological enzymes for purine metabolism, he needs to take for a long time.
2, 3Gout arthritis remission or interval
Clinical studies show that patients in the remission or interval ventilated arthritis can take benbromaron, thereby reducing blood uric acid levels and preventing acute attacks of gout . Clinical studies show that patients who have experienced gout can effectively control blood uric acid levels after taking benbromaron for 3-6 months of remission period after standardizing the treatment period, reducing uric acid deposition, reducing the number of attacks of acute gout, improving patients' prognosis, and protecting joint function. , but again emphasize that cannot be taken in the acute stage of gout.
3, gout nodules swelling
urate crystals are easily deposited in joints, organs and skin, and gout stones will form in joints, and gout nodules will appear subcutaneously, which will actually cause excessive uric acid levels, especially gout stones, which are very likely to cause joint deformities and affect joint activity. clinical studies show that oral benzylbromaron can effectively reduce the formation of gout or gout nodules, reduce joint damage, and protect joint and internal organ functions .
5. If you take benzylbromalon scientifically, you should pay attention to 5 points
. The effect of benzylbromalon is fast and obvious, but it is highly dependent on renal function. Therefore, not all patients with gout and hyperuricemia can take it. They need to strictly grasp their indications and pay attention to possible adverse reactions during the use. Pay attention to the following 5 points when taking benzylbromalon scientifically.
1. Pay attention to the use of dosage
. The treatment of benzylbromalone is very personalized. The dosage of needs to be adjusted according to the changes in the uric acid level in the body. The conventional dose is 50mg each time, taken once a day, and taken after breakfast. During the use, the uric acid level is checked every 2-3 weeks. If the uric acid level drops steadily, there is no need to adjust the dose. If the uric acid level is still at a high level, it can be increased to 100mg each time. After the uric acid level drops, the adjustment is back to 50mg each time.
2. Pay attention to drinking more water
You must drink a lot of water during taking benzenebromalone, because benzenebromalone will increase urine excretion. recommends that patients drink at least 2L of drinking water every day to meet the needs to prevent and treat dehydration caused by excessive excretion of urine, or uric acid crystals induced by excessive excretion of uric acid.
3. Pay attention to monitoring liver and kidney function
The effect of benzene bromron is very dependent on renal function. Therefore, renal function must be checked every 1-2 months when taken for a long time. Mild renal function damage to has little effect on benzene bromron, and there is no need to stop the medication. If moderate to severe renal function occurs, moderate to severe renal function occurs. Impairment (i.e., the glomerular filtration rate of is less than 20ml/min), or patients who are found to have kidney stones and other diseases should temporarily stop the medication to prevent further damage to kidney function; secondly, liver is the main organ of metabolizing benbromalon, so long-term oral administration must monitor liver function. If abnormalities are found, the medication must be stopped immediately or the dose must be adjusted.
4. Pay attention to adverse reactions
. The maximum dose of benzylbromalon should not exceed 200mg, otherwise it is easy to induce excessive decline in uric acid levels and lead to uric acid crystallization, and it will be impaired to liver and kidney function. orally taking benzene bromron can easily lead to gastrointestinal discomfort, such as nausea, vomiting, diarrhea, etc. Therefore, it is recommended that patients take it after breakfast in the morning to alleviate gastrointestinal reactions; secondly, , a few patients will experience skin itching, redness in the face, erythema, photoallergy, etc. after taking benzene bromron, and most of them can tolerate itching. Finally, a very small number of patients will experience acute liver damage in the early stage of taking the medicine. This patient recommends using other drugs instead.
5. Pay attention to the use of medication for special groups
Pregnant women and women during breastfeeding , lack of relevant research data, and the safety is unknown; benbromalon is only suitable for adults and not for children, Therefore, children are banned from ; The physiological function of the elderly has decreased, and it is recommended to reduce the dose ; During the use of benbromalon, you should avoid taking hepatotoxic drugs to avoid acute liver damage.
6. Summary
To sum up, benzbromalone is a common drug for the treatment of hyperuricemia and gout remission. It can quickly and effectively reduce uric acid levels, reduce inflammatory reactions, protect the kidneys, and improve patient outcomes. However, it is necessary to pay attention to the dosage and adverse reactions of the drug. It is recommended that patients in need take medication under the guidance of a doctor; secondly, drug treatment is only part of it. Patients with hyperuricemia or gout should improve their living habits based on taking medication, refuse a high-purine diet, eat more, and exercise in moderation, so as to fundamentally prevent and treat gout.
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