GOUT Flashcards
Elevation of uric acid
Gout
deposit of uric acid crystals in one or more joints
Gout
sodium urate crystals
Gout
painful flares lasting days to weeks followed by long periods without symptoms
Gout
What is gout
-Elevation of uric acid
-deposit of uric acid crystals in one or more joints
-sodium urate crystals
-painful flares lasting days to weeks followed by long periods without symptoms
Etiology of Gout
-Heredity
-Medications
-Prolonged fasting or excessive alcohol
Etiology of Gout in heredity
-primary hyperuricemia
Etiology of Gout in medications
-secondary hyperuricemia
- inhibit uric acid excretion
- examples: loop diuretics; b blockers
what happens to the condition of gout if there is a prolonged fasting and excessive alcohol
increase the production of keto acids; inhibit uric acid excretion
What is the Pathophysiology of Gout?
-Crystallization and inflammation
-Metabolic syndrome
Explain the crystallization and inflammation in the pathophysiology of Gout
-saturation of the synovial fluid or soft tissues by urates
-urates coalesce crystals
-inflammatory mediators are released
what are the metabolic syndrome?
-obesity
- insulin resistance
- hypertension
- hyperlipidemia
Clinical Manifestations of gout
Chronic Gout
multiple joint involvement
Chronic gout
visible deposits of sodium urate crystals
Chronic gout
What is chronic gout?
-multiple joint involvement
-visible deposits of sodium urate crystals
-tophi
What is tophi?
-visible deposits of sodium urate crystals
-occurs many years after the onset of the disease
occurs many years after the onset of the disease
tophi
Complications of Gout
-kidney stones
-urinary tract stones
-pyelonephritis
what is pyelonephritis?
sodium urate deposits
Diagnostics of Gout
-History and physical examination
-Elevated serum uric acid levels
-Elevated uric acid levels in 24-hr urine collection
-Preradiographic studies
-Synovial fluid aspiration
What is the gold standard diagnostic of Gout?
Synovial fluid aspiration
Nutritional Management of Gout
-dietary avoidance of food and fluids with high purine content
Examples of high purine content foods
-anchovies
-liver
-wine
-beer
What are the medical management of Gout
-Colchicine
-Xanthine oxidase inhibitor
- Selective xanthine oxidase inhibitor
- Uricosurics
- Corticosteroids
-NSAIDs
Anti-inflammatory; no analgesics properties
Colchicine
this drug can be combined with NSAIDs
Colchicine
Pain relief of colchicine
Pain relief within 12 hours of an attack
This drug is hepatotoxic and nephrotoxic
Colchicine
What is colchicine?
-anti-inflammatory; no analgesics properties
- combined with NSAIDs
- given orally
- pain relief within 12 hours of an attack
- hepatotoxic and nephrotoxic
urate lowering medication
xanthine oxidase inhibitor
What is the role of xanthine oxidase inhibitor?
prevents future attacks of gout
example of xanthine oxidase inhibitor drug
Allopurinol (Zyloprim)
What is xanthine oxidase inhibitor?
-urate-lowering medication
- prevents future attacks of gout
- given orally
-Allopurinol (Zyloprim)
This drug is given for long term management for chronic gout
Selective xanthine oxidase inhibitor
Example of selective xanthine oxidase inhibitor drug
Febuxostat (Uloric)
What is selective xanthine oxidase inhibitor?
-given for long term management for chronic gout
-taken orally
-Febuxostat (Uloric)
This drug enhances uric acid secretion in the urine
Uricosurics
This drug prevents attacks; does not cure gout
Uricosurics
Example of Uricosurics drug
Probenecid (Benuryl)
What is Uricosurics?
-enhances uric acid secretion in the urine
-prevents attacks; does not cure gout
-given orally
-Probenecid (Benuryl)
this drug is anti-inflammatory
corticosteroids
Corticosteroids can be given in what?
Corticosteroids can be given either orally or by intra-articular injection
Example of corticosteroids drug
Prednisone (Prolix)
what is corticosteroids?
-Anti-inflammatory
-given either orally or by intra-articular injection
Example of NSAIDs drug
Naproxen (Naprosyn)
Nursing Management of Gout
-pain management
- warm compress
- cold compress
- bed rest to immobilize affected joint
Purpose of warm compress in the management of gout
done between attacks to reduce general pain and stiffness
Purpose of cold compress
done during attacks to relieve pain and inflammation
how many minutes to use cold compress?
20-30 mins
