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NURS 572 Ch 73 gout

pharm - ch 73 - gout

QuestionAnswer
gout is usually, but not always characterized by hyperuricemia
acute episodes are ALWAYS characterized by urate crystals in joint fluid
what causes hyperuricemia/urate crystals excessive production of uric acid-----impaired renal excretion of uric acid
Acute tx of gout includes tx for pain, inflammation using these 3 classes of drugs anti-inflam/cholchicine----NSAIDs---corticosteroids
PREVENTION of gout bwo 2 mechanisms decrease prodcution of uric acid---increase excretion (uricosuric)
anti-inflamm agent to treat ACUTE gouty attack while offering some bridging to prevent subsequent attack colchicine - oral
We only give colchicine for 2 doses - why wicked GI SEs n/v/DIARRHEA----rare nephrotoxicity
name 2 drugs that are for chronic use/preventative ---lower uric acid levels allopurinol---febuxostat
MOA of drugs to lower uric acid = allopurinol, febuxostat inhibit xanthine oxidase so it can't convert purines to uric acid
are drugs to lower uric acid preventative? yes, if there's less uric acid, then we are preventing goit
why don't we use febuxostat as often $$$ but it works same as allopurinol
ADRs allopurinol gen well tolerated-----Rare----hypersensitivity syndrome = rash/fever/eosinophilia/liver/kidney dysfunciton----cataracts-----GI,HA
ADRs febuxostat same as allopurinol except no dermatological hypersensitivity
name 2 uricosurics that increase urinary excretion of uric acid probenecid-----sulfinpyrazone
why use uricosurics only for PREVENTION of attacks----NO BENEFIT for acute gouty attack
ADRs/class of probenecid and sulfinpyrazone uricosurics with these ADRs---risk of nephrolithiasis---PT MUST DRINK 2-3 LITERS OF WATER PER DAY ---GI---hypersensitivity reactions
Created by: lorrelaws