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11 Cards in this Set

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Gout

UA and leukocytes in synovial fluid

Hyperuricemia - pt asymptomatic

Risk factors

Male

Age

Hyperuricemia

BUN

BP

Cr

Weight

Etoh

Causes of hyperuricemia

  1. DKA and lactic acidosis
  2. alcohol
  3. Hypothyroidism
  4. Acromegaly
  5. Chronic hemolytic anemia
  6. Obesity
  7. Hypo or hyper parathyroidism
  8. Myeloproliferative and lymphoproliferative disorders

Drugs that decreased uric acid filtration

  1. thiazide and Loop diuretics
  2. Nicotinic acid
  3. Salicylates
  4. Alcohol
  5. Level dopa carbidopa
  6. Ethambutol
  7. pyrizinamide
  8. ticagrelor brilinta

Acute treatment of gout

  1. colchicine
  2. NSAIDs
  3. steroids

Chronic treatment of gout

  1. allopurinol
  2. febuxostat uloric
  3. Colchicine/probenecid
  4. Pegloricase krystexxa - only for adults with chronic gout refractory to standard therapy

NSAID

Indomethacin is as effective as cotrustee in but any and said can be used

Indomethacin does 75 mg to start then 50 mg every six hours for two days then 50 mg every eight hours for another two days do not use salicylates because they can increase your gas levels and can antagonize probenecid and sulfa pyrazines

Use caution in patients with coronary artery disease disease chronic renal insufficiency congestive heart failure and peptic ulcer disease

Steroids

  • prednisone 30 to 60 mg daily by mouth for 3 to 5 days then taper over 10 to 14 days to avoid rebound attacks
  • Intra-articular triamcinolone 20 to 40 mg if only at single joint

Xanthene oxidase inhibitor's

Allopurinol and uloric

Allopurinol

  • 200 to 300 mg daily for mild cases
  • 400 to 6 mg hundred milligrams daily for moderate to severe cases
  • Maximum 800 milligrams a day
  • not recommended for asymptomatic hyperuricemia not start in acute setting
  • Reno dosage adjustment is required can interfere with perimeter in metabolism
  • Can cause a rash including Stevens-Johnson Ashley with chronic kidney disease
  • Since drug interactions azathioprine mercaptopurine theophylline

Uloric

  • avoid starting in acute setting
  • More specific inhibitor to only purine metabolism through more selective inhibition of xanthene oxidase
  • notice adjustments for mild to moderate renal impairment or hepatic impairment
  • Directions is that I am praying for P rain theophylline