Arthritis, gouty

Rheumatic disorders Decreased inflammation and immunosuppression Ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis, gouty arthritis, osteoarthritis... [Pg.424]

Thus, the presence of uric acid crystals in joints triggers a vicious cycle, resulting in an extremely painful inflammation. A typical localization of acute gouty arthritis is the first metatarsal joint of the foot (podagra). The diagnosis of acute gouty arthritis is confirmed by the detection of urate crystals in the joint or tophus. [Pg.136]

Daily doses of 3-8 mg (6-8 times 0.5-1.0 mg) are used for the treatment of acute gouty arthritis. For prophylaxis, daily doses of 0.5-1.5 mg are used, but the use of colchicine for prophylaxis is controversial. [Pg.138]

Hyperuricemia is defined as serum uric acid concentration >416 p mol/L or 7.0 mg/dL. With increasing serum uric acid concentration, the risk of acute gouty arthritis increases, but asymptomatic hyperuricemia does not have to be treated pharmacologically. [Pg.608]

Tubulin is a major component of the cellular cytoskele-ton. Tubulin polymers (microtubules) are important for cell division (mitotic spindle) and the chemotaxis and phagocytosis of neutrophils. Prevention of tubulin polymerisation by colchicine accounts for the therapeutic effects of this drug in acute gouty arthritis and its anti-mitotic effects. [Pg.1247]

Uric acid is the endproduct of purine metabolism in man. Uric acid has a lower solubility than its progenitor metabolites, hypoxanthine and xanthine. Impaired uric acid elimination and/or increased uric acid production result in hyperuricemia and increase the risk of gouty arthritis. At physiological pH, 99% of the uric acid molecules are actually in the form of the urate salt. A decrease in pH increases the fraction of uric acid molecules relative to urate molecules. Uric acid possesses lower solubility than urate. [Pg.1267]

Mild to moderate pain, rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, gouty arthritis... [Pg.161]

Certain drugs bind to microtubules and thus interfere with their assembly or disassembly. These include colchicine (used for treatment of acute gouty arthritis), vinblastine (a vinca alkaloid used for treating certain types of cancer), paclitaxel (Taxol) (effective against ovarian cancer), and griseoflilvin (an antifungal agent). [Pg.577]

Prior inflammatory disease (rheumatoid arthritis, chronic gouty arthritis, pseudogout, infectious arthritis)... [Pg.881]

Develop a pharmacotherapeutic plan for a patient with acute gouty arthritis or uric acid nephropathy that includes individualized drug selection and monitoring for efficacy and safety. [Pg.891]

Educate patients on appropriate lifestyle modifications to help prevent gouty arthritis... [Pg.891]

Treatment of gout involves (1) acute relief of a gouty arthritis attack and (2) in some patients long-term maintenance treatment to prevent future attacks. [Pg.891]

If the diagnosis is an acute attack of gouty arthritis, what treatment plan would you outline for this patient ... [Pg.895]

Allopurinol is well absorbed with a short half-life of 2 to 3 hours. The half-life of oxypurinol approaches 24 hours, allowing allopurinol to be dosed once daily. Oxypurinol is cleared primarily renally and can accumulate in patients with reduced kidney function. Allopurinol should not be started during an acute gout attack because sudden shifts in serum uric acid levels may precipitate or exacerbate gouty arthritis. Rapid shifts in serum uric acid can change the concentration of monosodium urate crystals in synovial fluid, causing more crystals to precipitate. Thus some clinicians advocate a prophylactic dose of colchicine (0.6 mg/day) during initiation of antihyperuricemic therapy. Acute episodes should be treated appropriately before maintenance treatment is started. [Pg.896]

Assess for new gouty arthritis attacks or the development of tophi. If neither one develops, continue antihyperuricemic... [Pg.897]

Schlesinger N. Management of acute and chronic gouty arthritis. Drugs 2004 64 2399-2416. [Pg.898]

Pyrazinamide Adults Based on IBW 40-55 kg 1000 mg 56-75 kg 1500 mg 76-90 kg 2000 mg Children 15-30 mg/kg Hepatotoxicity, gastrointestinal symptoms (nausea, vomiting), non-gouty polyarthralgia, asymptomatic hyperuricemia, acute gouty arthritis, transient morbilliform rash, dermatitis Serum uric acid can serve as a surrogate marker for compliance FFTs in patients with underlying liver disease... [Pg.1113]

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