Gout Flashcards
What is Gout
uric acid metabolism
deposit of urate salts
what is gouty arthritis
Urate crystals in synovial fluid
Acute, painful inflammation
What is tophaceous gout
Advanced stage
Tophi
what is uric acid
waste product of purine metabolism
what is purine
compund containing nitrogen
sources of purine
Alcohol
Organ meat (liver)
Red meat
Seafood, shell fish
Risk Factors of Gout
Male genetics high purine diet obesity diuretic therapy + kidney insufficiency
Patho of Gouty Arthritis
Elevated Uric Acid Levels / Uric acid accumulates in body fluids / Formation of urate crystals / Deposition in or around joint(s) / Inflammation / Gouty Arthritis
Manifestations of Gouty arthritis
Pain
Intense pain
Great toe
Early morning
Inflammation
Edema
Tenderness
Redness
Fever
Malaise
Complications of Gout and Gouty Arthritis
Urate Kidney Stones
Pharmacotherapy of Gout and gouty arthritis
+Acute
NSAIDs
Corticosteroid therapy
Colchicine (Colcrys)
+Prophylactic
Allopurinol (Zyloprim)
Colchicine (Colcrys)
Probenecid (Benuryl)
Antigout Agent
Allopurinol (Zyloprim)
MOA of allopurinol
inhibits production of uric acid
what is the therapeutic use of allopurinol
prophylaxis
SE of allopurinol
Rash
Interactions of allopurinol
hypoglycemic agents
warfarin
Nursing implications of Allopurinol
+If gastric irritation
take w/ food or milk
+Monitor
Serum/urine uric acid
Serum glucose
may cause hypoglycemia
+Time to improvement?
2-6 weeks
Anti-inflammatory / Anti-gout agent
Colchicine (colcrys)
MOA of colchicine
Mostly unknown; inhibits leukocyte infiltration (disrupts cell division)
Therapeutic Use of Colchicine
Gout flares and prophylaxis
SE of colchicine
GI effects - stop colchicine
precautions of colchicine
usually given orally
contraindicated in renal disease
Monitor flu like systems -> drug toxicity
IV not given in US
Nursing implications of colchicine
+Teach patient to avoid:
Alcohol
Grapefruit
B12 vitamins
\+Check for other drugs that could interact with Colchicine: CYP3A4 Inhibitors: Clarithromycin Lanoxin (Digoxin) Statins Numerous others
Uricosuric Agent
Probenecid (Benuryl)
MOA of probenecid
inhibits reabsorption of uric acid in kidney, promoting excretion
Therapeutic uses of probenecid
treats hyperuricemia with gout
Recommendatoins of probenecid
Used alone or in combo with allopurinol when not effective alone
SE of probenecid (4)
GI upset
Dizziness or headache
Kidney/Liver impairment
Lots of drug interactions
