Gout

Question 1

What is Gout

Answer 1

uric acid metabolism

deposit of urate salts

Question 2

what is gouty arthritis

Answer 2

Urate crystals in synovial fluid

Acute, painful inflammation

Question 3

What is tophaceous gout

Answer 3

Advanced stage

Tophi

Question 4

what is uric acid

Answer 4

waste product of purine metabolism

Question 5

what is purine

Answer 5

compund containing nitrogen

Question 6

sources of purine

Answer 6

Alcohol
Organ meat (liver)
Red meat
Seafood, shell fish

Question 7

Risk Factors of Gout

Answer 7

Male
genetics
high purine diet
obesity
diuretic therapy + kidney insufficiency

Question 8

Patho of Gouty Arthritis

Answer 8

Elevated Uric Acid Levels
/
Uric acid accumulates in body fluids 
/
Formation of urate crystals
/
Deposition in or around joint(s)
/
Inflammation
/
Gouty Arthritis

Question 9

Manifestations of Gouty arthritis

Answer 9

Pain
Intense pain
Great toe
Early morning

Inflammation
Edema
Tenderness
Redness

Fever

Malaise

Question 10

Complications of Gout and Gouty Arthritis

Answer 10

Urate Kidney Stones

Question 11

Pharmacotherapy of Gout and gouty arthritis

Answer 11

+Acute
NSAIDs
Corticosteroid therapy
Colchicine (Colcrys)

+Prophylactic
Allopurinol (Zyloprim)
Colchicine (Colcrys)
Probenecid (Benuryl)

Question 12

Antigout Agent

Answer 12

Allopurinol (Zyloprim)

Question 13

MOA of allopurinol

Answer 13

inhibits production of uric acid

Question 14

what is the therapeutic use of allopurinol

Answer 14

prophylaxis

Question 15

SE of allopurinol

Answer 15

Rash

Question 16

Interactions of allopurinol

Answer 16

hypoglycemic agents

warfarin

Question 17

Nursing implications of Allopurinol

Answer 17

+If gastric irritation
take w/ food or milk

+Monitor
Serum/urine uric acid
Serum glucose
may cause hypoglycemia

+Time to improvement?
2-6 weeks

Question 18

Anti-inflammatory / Anti-gout agent

Answer 18

Colchicine (colcrys)

Question 19

MOA of colchicine

Answer 19

Mostly unknown; inhibits leukocyte infiltration (disrupts cell division)

Question 20

Therapeutic Use of Colchicine

Answer 20

Gout flares and prophylaxis

Question 21

SE of colchicine

Answer 21

GI effects - stop colchicine

Question 22

precautions of colchicine

Answer 22

usually given orally
contraindicated in renal disease

Monitor flu like systems -> drug toxicity

IV not given in US

Question 23

Nursing implications of colchicine

Answer 23

+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

Question 24

Uricosuric Agent

Answer 24

Probenecid (Benuryl)

Question 25

MOA of probenecid

Answer 25

inhibits reabsorption of uric acid in kidney, promoting excretion

Question 26

Therapeutic uses of probenecid

Answer 26

treats hyperuricemia with gout

Question 27

Recommendatoins of probenecid

Answer 27

Used alone or in combo with allopurinol when not effective alone

Question 28

SE of probenecid (4)

Answer 28

GI upset Dizziness or headache Kidney/Liver impairment Lots of drug interactions