Colchicine (Molecule of the Month for August 2020)
Colchicine is a medication used to treat gout and Behçet's disease.In gout, it is less preferred to nonsteroidal anti-inflammatory drug or steroids. Other uses for colchicine include the prevention of pericarditis and familial Mediterranean fever. Colchicine, in the form of the autumn crocus (Colchicum autumnale), has been used as early as 1500 BC to treat joint swelling. It was approved for medical use in the United States in 1961. It is available as a generic medication in the United Kingdom. In 2017, it was the 201st-most commonly prescribed medication in the United States, with more than two million prescriptions. Its anti-inflammatory effects mean it is being tested to help with covid-19 infections.
Colchicine has a narrow therapeutic index and overdosing is therefore a significant risk. Deaths both accidental and intentional have resulted from overdose of colchicine. Common side effects of colchicine include gastrointestinal upset, particularly at high doses. Severe side effects may include low blood cells and rhabdomyolysis, and the medication can be deadly in overdose.
Colchicine works by decreasing inflammation via multiple mechanisms. In gout, inflammation in joints results from the precipitation of circulating uric acid, exceeding its solubility in blood and depositing as crystals of monosodium urate in and around synovial fluid and soft tissues of joints. These crystal deposits cause inflammatory arthritis, which is initiated and sustained by mechanisms involving various proinflammatory mediators, such as cytokines. Colchicine accumulates in white blood cells and affects them in a variety of ways: decreasing motility, mobilization (especially chemotaxis) and adhesion.
Formal Chemical Name (IUPAC)
Update by Karl Harrison
(Molecule of the Month for August 2020 )
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