Please enable JavaScript.
Coggle requires JavaScript to display documents.
GOUT (Monitoring (elevation of hepatic enzymes, signs of eosinophilia,…
GOUT
-
-
Treatment
Non-Pharm
-
-
-
eliminate diuretics, niacin, and calcineurin inhibitors if not needed
pharmacologic
hyperuricemia
ULT initiation
First line
allopurinol
MOA: decrease the production of uric acid by inhibiting the action of xanthine oxidase, the enzyme that converts hypoxanthine to xanthine and xanthine to uric acid.
-
rash, fatal hypersensitivity syndrome
febuxostat
-
liver enzyme elevation, nausea, arthralgias, rash
-
-
prophylaxis
first line:
low dose colchicine
-
dose-dependent GI AE, rare myelosuppresion, reversible neuromyopathy
MOA: interference with migration of neutrophils to sites of inflammation that have been induced by deposits of monosodium urate crystals in synovial fluid
low dose NSAID
AE: renal dysfunction, gastritis, fluid retention, BP elevation
-
-
-
diagnosis
aspiration of synovial fluid from the affected joint and identification of intracellular crystals of MSU monohydrate in synovial fluid leukocytes
-
Goals
terminate the acute attacks, prevent recurrent attacks of gouty arthritis, and prevent complications associated with chronic deposition of urate crystals in tissues
s/sx
fever, intense pain, erythema, warmth, swelling, and inflammation of involved joints
-