A number of drugs other than those discussed in detail in this chapter have been used to control the symptoms of acute gouty arthritis. Since the principal aspects of their pharmacology have been described elsewhere, they are mentioned only briefly here.
Indomethacin (Indocin) (see Chapter 36) exerts an-tiinflammatory, antipyretic, and analgesic properties. These qualities make it useful for the short-term management of the symptoms of acute gouty arthritis, although it has little effect on serum uric acid levels. Its antiinflammatory activity and ability to inhibit leuko-cytic phagocytosis make it particularly valuable in treating the early stages of gout, because a decrease in the leukocytic phagocytosis of urate crystals results in a decrease in the amount of peptides, prostaglandins, and other substances released from leukocyte lysosome organelles.
Phenylbutazone (Butazolidin, Tandearil) (see Chapter 36) also displays antipyretic, analgesic, and antiinflam-matory activity. In addition, it possesses some uricosuric potency and therefore is widely used for the treatment of acute attacks of gouty arthritis, in which it is about equal to colchicine in effectiveness. Although the drug does promote the renal excretion of uric acid, its usefulness is generally attributed to its antiinflammatory actions.
Oxyphenbutazone (Oxalid, Tandearil) is the principal uricosuric metabolite of phenylbutazone. It has the same indications and toxicities as phenylbutazone.
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