Download - 201306 痛風與退化性關節炎的藥物治療 講義版

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The old disease in the modern setting

19 26.1% 17.0%2Gout history:(hyperuricemia)? 50

5

::15-25%5-18%Risk factors:Baseline risk factors Inducing factors

Lin YC, Lin KC, Lee SS, Lin HY. Journal of Internal Medicine of Taiwan 2005;16:71-8. Risk factors:

biological , , , , , , ,

Behavior

environmental, 637C6.8 mg/dL 7.0 mg/dL6.0 mg/dL

7 10%90%

9

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6 mg/dL 7 mg/dL7 mg/dL 6 mg/dL 5 mg/dL

11201210: (Colchicine) (NSAID, nonsteroid anti-inflammatory drug)(Corticosteroid)(NSAID)FDA approved NSAID for the treatment of acute gout: Naproxen (evidence A)Indomethacin (evidence A)Sulindac (evidence B)Analgesic and antiinflammatory doses of other NSAIDs may be as effective (evidence B and C)NSAIDTFPLoading dose: 1.0 mg, followed by 0.5 mg 1 hour later12 hourscolchicine (up to 0.5 mg 3 times daily) (evidence C). TFPlow dose colchicine (0.6 mg once or twice daily) (evidence A) or low dose NSAID (evidence C)low dose prednisolone (