Gout Flashcards
gout
uric acid metabolism
deposits of urate salts
gouty arthritis
urate crystals in synovial fluid
acute and painful inflammation
chronic tophaceous gout
advanced stage gout
tophi
uric acid
waste product of purine metabolism
what is purine
compound containing nitrogen
sources of purine
alcohol organ meat (liver) red meat seafood, shellfish primarily excreted by kidneys
predisposing factors of gout
male genetics diet obesity diuretic therapy + kidney insufficiency
pathogenesis of Gouty arthritis
elevated uric acid levels uric acid accumulates in body fluids formation of urate crystals deposition in or around joints inflammation
gouty arthritis manifestations
pain (great LT toe, early morning)
edema, tenderness, redness
fever
malaise
complications of gout and gouty arthritis
uric kidney stones
Meds for acute gouty arthritis
NSAIDS
corticosteroids
colchicine
prophylactic meds for gouty arthritis
allopurinol
colchicine
probenecid
allopurinol
antigout
inhibits production of uric acid
given prophylaxis
se: rash
important drug interactions with allopurinol
hypoglycemic agents
warfarin
nursing implication for allopurinol
gastric irritation, take with milk or food
monitor serum/urine uric acid
monitor serum glucose (can cause hypoglycemia)
2-6 weeks before improvement
colchicine
anti-inflammatory, anti-gout inhibits leukocyte infiltration (disrupts cell division) used for gout flares and prophylaxis given orally CONTRAINDICATED in renal disease
side effects of colchicine
GI upset- stop colchicine
nursing implications for colchicine
AVOID: alcohol, grapefruit, B12 vitamins
types of drugs that have interactions with colchicine
CYP3A4 inhibitors: clarithromycin
digoxin (lanoxin)
statins
probenecid
uricosuric agent
inhibits reabsorption of uric acid in kidney, promoting excretion
treats hyperuricemia with gout
can be used alone or in combo with allopurinol when not effective alone
side effects of probenecid
GI upset
dizziness or headache
kidney/liver impairment
lots of drug interactions
