Gout Medications Flashcards
Patho of Gout
-body constantly making new cells to replace old ones
-when old cell dies, various waste products leaks into the bloodstream
- DNA is a waste product
-the body turns this DNA into hypoxanthine
- Xanthine oxidase breaks down hypoxanthine into xanthine
- Xanthine oxidase breaks xanthine dow into uric acid
-kidneys usually filter uric acid, allowing you to pee it out
-People w/ gout usually have too much uric acid or cannot excrete it fast enough
-uric acid crystallizes in bloodstream
-clients w/ gout have buildups of uric crystals called trophi in their joints–especially in the lower extremities. These trophi cause inflammation and pain
People w/ Gout should avoid food that are
-rich in purines (such as red meat, shellfish, beer)
& fruit juice
Signs & Symptoms of Gout
-sudden, intense joint pain (gout flares or attacks)
-Most often this involves the base of the big toe, but it can occur in any joint.
-These areas become inflamed and red.
-Gout flares are worst in the first several hours, but the pain often persists for many days.
Medication options for Gout
-Occasional gout flares can be treated with NSAIDs or glucocorticoids.
-For more severe cases, the two most commonly prescribed medications are colchicine and allopurinol.
Colchicine Common Uses
prescribed for acute gout attacks and for maintenance therapy.
what is the most common problem with colchicine?
GI issues (nausea, vomiting, diarrhea)
what is the most common problem with colchicine?
GI issues (nausea, vomiting, diarrhea)
what is a rare side effect of colchicine?
-rhabdomyolysis. Clients should report muscle plains.
-Taking a statin significantly increases the risk of rhabdomyolysis
Allopurinol Common Uses
-prescribed for acute gout attacks and for maintenance therapy.
- also prescribed for hyperuricemia caused by chemotherapy.
Allopurinol Mechanism of Action
-Allopurinol is a xanthine oxidase (XO) inhibitor. When you block this enzyme, you don’t get much nearly as much xanthine or uric acid in the bloodstream.
- hypoxanthine has not been broken down, Hypoxanthine is very water-soluble. That means it doesn’t crystalize and the kidneys have no trouble excreting it.
How can Allopurinol become life-threatening?
it can cause hypersensitive reactions
-patient should notify provider if they develop a fever and rash
Clients taking allopurinol should stay ____ _____ to prevent _____ ______
well hydrated (2.5-3 L per day); kidney stones
