GOUT

Question 1

Purines-end product of protein digestion and it breaks down into uric acid–> Urate crystals deposit in joints, causing
inflammation

Answer 1

Gout

Question 2

Most common form of gout, inherited, middle aged and older men, post-menopausal women

Answer 2

Primary

Question 3

Hyperuricemia caused by another disease/factor (for example, renal insufficiency, diuretics, crash diets

Answer 3

Secondary

Question 4

S/Sx of Gout

Answer 4

o Asymptomatic (elevated serum uric acid)
o Acute (excruciating pain usually in the metatarsophalangeal joint of the great toe, called podagra)
o Tophaceous- repeated episodes (usually between 3-40 years after the 1st symptoms appear. Results in urate crystals under the skin and within major organs, often within the kidney. Kidney stones are common.

Question 5

Labs & Diagnostics

Answer 5

-Serum uric acid & urinary uric acid levels
-Kidney function tests (chronic)
-Synovial fluid aspiration (arthrocentesis)

Question 6

Why should aspirin be avoided?

Answer 6

because it inactivates the effects of the drug therapy

Question 7

• Inhibit migration of leukocytes to inflamed site (anti-inflammatory)
• Uses: Decreases pain and inflammation in acute gout attacks, prevents future gout attacks
• Side effects: GI distress
• Nursing Implications: Taken with food to avoid GI distress and avoid grapefruit juice
• Contraindications: Severe renal, cardiac, or GI problem

Answer 7

Antigout Drugs: Colchicine

Question 8

• Not an anti inflammatory drug
• Inhibits final steps of uric acid biosynthesis and lowers serum uric acid levels (prevents uric acid from forming)
• This will prevent an attack
• Frequently used as a prophylactic to prevent gout, long term-use

Answer 8

Antigout Drug: Allopurinol

Question 9

STRICT LOW PURINE DIET

Answer 9

No organ meat, shellfish, oily fish with bones (sardines), no excessive alcohol intake, no fat diets, no aspirin or diuretics, avoid stress.

Drink plenty of water and fluids