Pathophysiology of Gout
When a cell dies, the DNA spills out and eventually turns into uric acid
Uric acid is not H2O soluble and crystallizes, leading to redness, swelling of joint
If Gout happens 2-3 year, use —
If Gout happens 4 or more times a year use —-
NSAIDs or Glucocorticoids
Gout Meds
- allopurinol
- cochinicine
—– is the cornerstone of gout treatment.
Allopurinol
—– is a uric acid lowering drug.
Allopurinol
Works by blocking enzymes (XOs) that turn DNA into Uric Acid
How long does it take Allopurinol to take full effect?
1-2 months
Why is allopurinol useful for certain cancers?
Cancer patient can get gout due to cancer cells being killed off and DNA turning into Uric Acid
Allopurinol it destroys the cancer cells that are broken when cancer cells die
What tis the therapeutic goal when taking allopurinol?
Uric acid below 7 mg/dL in men and 6 mg/dL in women
A/E of allopurinol?
- Acute gouty attack (use NSAID to treat)
- Hypersensitivity Syndrome
- Hepatotoxicity
A/D of colchicine
- Diarrhea (25%)
- Myopathy
- Bone Marrow Suppression
Which drug should be monitored when taking colchicine?
-statin
Due to Myopathy —> rhabdomyolysis
What should we watch for in a client taking colchicine?
Bone Marrow Suppression
- monitor WBC, RBC, Platelets
- monitor for signs of ANEMIA
At what point should a client move from NSAIDs and Glucocorticoids to a Irate-Lowering Med like allopurinol?
When gout happens more than 3-4 times per year
If a client has a hypersensitive reaction while taking allopurinol, what should nurse do?
Stop the drug
Most common S/E of colchicine?
Diarrhea (25 %)
