What is gout?
A form of arthritis which is caused by the accumulation of uric acid crystals in joints
What can chronic gout cause?
- joint destruction
- decreased kidney function
What is uric acid from?
It's a breakdown product of purines
What is asymptomatic hyperuricemia?
A state of elevated levels of uric acid in the blood without symptoms
**Precursor to developing gout
What are the 2 types of gout?
- excessive production of uric acid
- reduced excretion of uric acid
What are some purine-rich foods?
- Organ meats - liver, brains, kidneys
What's a tophi?
Uric acid crystal deposit - usually in other tissues (helix of ear)
What are the 4 distinct stages of gout?
- Intercritical - no pain or swelling, relatively symptom free
- Chronic - tophi, polyarticular attacks
What drug treats gout by inhibition of neutrophil migration and phagocytic activity in inflamed joints?
What is the only indication for colchicine?
Acute attack of gout
What is a side effect of colchicine?
What gout medication inhibits xanthine oxidase, that inhibits the synthesis of uric acid?
What are the indications of allopurinol (Zyloprim)?
- Chronic gout
- Chemotherapy and radiation
What are the side effects of allopurinol (Zyloprim)?
- pruritic rash
- allergic skin and blood reactions
What gout medication increases the excretion of uric acid = "uricosuric agent"?
What are the indications for probenecid (Benemid)?
- Chronic gout
- When acute gout attacks increase in frequency and severity
What are 2 common problems with drug-to-drug interactions with probenecid (Benemid)?
Low dose aspirin - interferes with the uricosuric action of probenecid
- Increases plasma level of penicillin
Why are NSAIDS used to help manage acute arthritis pain and inflammation of gout?