Musculoskeletal Meds

Question 1

form of inflammatory arthritis that is severely painful

Answer 1

Gout

Question 2

Causes of Gout

Answer 2

Purines build up (caused by alcohol, brewer yeast and fructose)
> Uric acid develops and increases causing > Hyperuricaemia > Crystal precipitation occurs causing joints inflammation and kidney stones

Question 3

Pathology of gout inflammation

Answer 3

As uric acid crystals builds up (from uric acid deposits), WBC neutrophils engulf it.
HOWEVER, uric acid kills neutrophils causing INFLAMMATION

Question 4

acute treatment for GOUT inflammation

Answer 4

Corticosteroids
NSAIDs
Colchicine - inhibit neutrophils from engulfing uric acid crystals

Question 5

Pharmacodynamics of Colchicine

Answer 5

anti-gout agent relieving gout attacks and prevents it (DO NOT relief pain just inflammation) 
blocks release of cytokines
prevents neutrophil activation
increases anti-inflammatory mediators
inhibits uric acid deposits

Question 6

Pharmacodynamics of Allopurinol

Answer 6

Prevents gout attacks (not for acute treatment)

Inhibits conversion of Purines to Uric acid - causing a decrease in blood uric acid levels and uric acid deposition in the joints

Question 7

Side effects of Colchicine

Answer 7

GI upset:
N&V, abdominal pain and diarrhoea

Risk for bone marrow suppression

Question 8

Side effects of Allopurinol

Answer 8

GI upset: N&V, abdominal pain and diarrhoea

Skin rash

Question 9

Nursing consideration for Allopurinol

Answer 9

Stay hydrated and always take meds with water to prevent kidney stones - AVOID alcohol or any sweetened beverages
Strict UO up to 2L/ day
Several months of efficacy

DO NOT take Allopurinol with Aspirin as it increases uric acid levels
TAKE Acetaminophen instead

Question 10

Nursing consideration for Colchicine

Answer 10

Stay hydrated and take meds with water to prevent kidney stones - AVOID alcohol or any sweetened beverages
Strict UO up to 2L/day
Take several months of efficacy