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HYPERURICEMIA AND
GOUT
GOUT
-a chronic metabollic
disease associated
with the development
of hyperuricemia, the
presence of
abnormally elevated
amounts of uric acid in
the blood
HYPERURICEMIA
-may arise because of a reduction in
the renal elimination of uric acid, an
increase in uric acid production, or a
combination of these two factors
MANAGEMENT OF ACUTE
GOUTY ARTHRITIS
COLCHICINE
-drug of choice for acute attack of gout
-particularly beneficial in clients who
are hypersensitive to aspirin and
NSAIDs
CONTROL OF HYPERURICEMIA
-aimed at reducing serum urate levels
to below 6mg/dl
-at this level, tophi do not form within
the joints and tissues of the body
CONTROL OF HYPERURICEMIA
URICOSURIC AGENTS (Probenecid,
Sulfinpyrazone) increase the urinary
excretion of uric acid
XANTHINE OXIDASE INHIBITORS
(Allopurinol) preventing the formation
of uric acid in the body
URICOSURIC
AGENTS
Example: Probenecid
(Benemid),
Sulfinpyrazone (Anturane)
-these agents increase uric acid
excretion by preventing the
reabsorption of uric acid in the renal
tubules
NURSING IMPLICATIONS:
-encourage client to
drink large volumes
of water (10-12 8ounce glasses) daily
to prevent increase
UA concentration in
the urine
NURSING IMPLICATIONS:
-Sulfinpyrazone (Anturane) is capable
of affecting platelet function
XANTHINE OXIDASE
INHIBITORS
Example: Allopurinol
(Zyloprim)
-interferes with the conversion of
purines to uric acid by inhibiting the
enzyme xanthine oxidase
NURSING IMPLICATIONS:
-May cause skin rashes and/or
hepatotoxicty in some clients
-Avoid foods that are rich in purine
Salmon
Sardines
Scallops
Turkey
Veal