Categorii: Tot - treatment - excretion - inflammation

realizată de Felicia MedStudent 16 ani în urmă

452

Gout Treatment

Gout is a condition characterized by the formation of uric acid crystals, particularly in joints like the big toe. These crystals trigger an immune response, leading to inflammation and discomfort.

Gout Treatment

Gout Treatment

dz produced by the formation of uric acid crystals (tophi) in joints (b/c there's low fluid there), especially in the big toe

the crystals provoke an immune response

granulocytes respond and their high metabolic activity produces lactic acid, reducing pH and causing more uric acid to precipitate

CHRONIC

Increase uric acid excretion
Sulfinpyrazole

MOA same as probenecid

hypersensitivity not common

GI side effects

other uses:

antithrombic (like aspirin)

Probenecid (high doses)

@ high doses, inhibits secretion + reabsorbtion

  • incr. excretion
  • decr. plasma urate
  • (what we want in a gout treatment -- whatever's in there just passes right thru)

    @ low doses, inhibits secretion not reabsorbtion


  • decr. excretion
  • incr. plasma urate


  • drug must be in filtrate to act on transporters on the apical surface

    complications

    it antagonizes diuretics

    aspirin prevents its action

  • may use tylenol or naproxen instead
  • predisposes to kidney stone

  • b/c it decreases pH
  • GI disurbances

    other uses

    uncomplicated gonoccocal infxn

  • only takes one shot
  • MOA: inhibits penicillin excretion via nonspecific OAT 1 & 3
  • Reduce uric acid synthesis
    Allopurinol

    MOA: inhibits xanthine oxidase

  • 80% bioavailability
  • it is a xanthine isomer
  • Contraindications

    acute gouty attack

    may worsen an acute gouty attack if used as 1st tx

    ACUTE

    Reduce inflammation
    Colchicine

    MOA: inhibits activities of leukocytes (esp. granulocytes)

    AE:

    severe n/v, limits effectiveness