When uric acids crystals collect in the joints of the body, the result is a painful condition known as gout. Gout most frequently affects the base of the big toe, but can also be found in the ankle, knee, or rarely, the shoulder. It strikes when the body produces an excessive amount of uric acid, either through increased breakdown of purines, which are found in cellular DNA, or through decreased excretion of uric acid in the urine. Certain types of medication have been associated with causing or exacerbating gout.
Thiazide Diuretics
Hypertension is sometimes treated with thiazide diuretics, or water pills, which decrease blood volume by encouraging the excretion of excess water, thus diminishing pressure placed on the blood vessel walls. The New York Times Health Guide reports that 75 percent of older patients who develop gout have a history of diuretic use.
Diuretics prompt the body to excrete sodium and water. In response the blood volume decreases. The decrease in volume causes an increase in the resabsorption of uric acid. Current guidelines contraindicate the use of diuretics for hypertension in those who have gout, according to the journal "Annals of the Rheumatic Diseases".
Aspirin
Baby aspirin is often recommended in low doses for older people who are at risk of heart disease. This may have the counter-effect of increasing the levels of uric acid in the body. The New York Times Health Guide says that low doses of aspirin decrease the excretion of uric acid and can increase the chance of gout.
Anti-rejection Drugs
When organs are transplanted in patients, they are administered anti-rejection drugs to decrease the likelihood of their body identifying the new organs as foreign pathogens and mounting an immune response. Cyclosporine is one type of anti-rejection drug, and it is commonly used to reduce the chance of rejection when a kidney, heart or liver is transplanted. The Journal of the American Society of Nephrology notes that cyclosporine decreases the excretion of uric acid in the urine.
Due to the clear relationship of cyclosporine and increased hyperuricemia, it has been recommended that transplant patients who are predisposed to high levels of uric acid in the blood should receive treatments for lowering uric acid simultaneously with cyclosporine. This reduces the risk of developing gout.
