GOUT medications
▪ Lab Values
o RFP, BUN, CR
Colchicine.
▪ Low dose is 1.2mg followed by 0.6mg one hour later or 1.8 milligrams total
▪ High dose is 1.2mg followed by 0.6mg every four to six hours; or 4.8mg to
...
GOUT medications
▪ Lab Values
o RFP, BUN, CR
Colchicine.
▪ Low dose is 1.2mg followed by 0.6mg one hour later or 1.8 milligrams total
▪ High dose is 1.2mg followed by 0.6mg every four to six hours; or 4.8mg total.
▪ Low dose is as effective as high dose with lower side effects
▪ Side Effects
o Always causes severe diarrhea Febuxostat (Uloric)
▪ Initially gout may worsen Corticosteroids
▪ Side effects when administered 6+ months
o Osteoporosis
o Can worsen diabetes control
o Patients should report any black tarry stools and abdominal pain
▪ Why Taper?
o Tapering must be done carefully to avoid both recurrent activity of the underlying disease process and possible cortisol deficiency resulting from the hypothalamic – pituitary – adrenal axis or HPA suppression during the period of steroid therapy
NSAIDS
▪ Increase risk of serious cardiovascular thrombotic events (MI and Stroke) may be fatal: May increase with duration of use.
▪ Patients with prior heart issues are more at risk.
▪ Serious GI effects (bleeding, ulceration, perforation) Elderly at more risk
▪ Can occur at any time with no warning
▪ For Pain start with NSAIDS and work your way up with medications Ibuprofen
▪ Inhibiting the cox enzymes cox which is cyclooxygenase is officially known as the
prostaglandin-endoperoxide synthase (PTGS), which converts arachidonic acid to prostaglandin h2 or PGH2.
▪ PGH2. In turn is converted by other enzymes to several other prostaglandins which are mediators of pain, inflammation, and fever, and to thromboxane-A2 which stimulates platelet aggregation leading to the formation of blood clots.
▪ Ibuprofen is a non-selective inhibitor of cyclooxygenase, its pharmacological effects are believed to be due to inhibition of cox-2 which decreases the synthesis of prostaglandins in mediating the inflammation pain, fever, and swelling.
▪ * Familiarize with COX pathways
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