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Understanding Gout: Treatment & Medications

Learn about gout, its stages, non-pharmacologic therapy, NSAIDs, Colchicine, Corticosteroids, Xanthine Oxidase Inhibitors, and Allopurinol in this comprehensive lecture. Understand mechanisms of action, side effects, drug interactions, and therapeutic uses.

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Understanding Gout: Treatment & Medications

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  1. GOUT

  2. By • Prof. Azza El-Medany • Dr. Osama Yousf

  3. OBJECTIVES • At the end of lectures students should : • Define gout • Describe outlines of treatment • Describe treatment of acute gouty arthritis • Describe the mechanism of action , clinical uses & side effects of drugs used in acute attacks

  4. OBJECTIVES ( continue) • Classify drugs used in chronic treatment • Define each group of drugs • Describe the mechanism of action, clinical uses & side effects & drug interactions for drugs used in chronic treatment

  5. What is gout? Breakdown of product of the body’s purine (nucleic acid) metabolism.

  6. Aaarrrgghhh!!

  7. What is the treatment for gout ?

  8. Clinical stages of Gout

  9. ASYMPTOMATIC STAGE • urate levels rise in the blood, but produces no symptoms

  10. ACUTE STAGE

  11. INTERCRITICAL STAGE • symptom-free intervals between gout episodes. Most people have a second attack from six months to two years, while others are symptom-free for five to 10 years.

  12. CHRONIC STAGE

  13. Non-pharmacologicTherapy

  14. Control….

  15. 1. NSAIDs

  16. NSAIDs (Selective or non- selective ) • Inhibit pain & inflammation. • Inhibit urate crystal phagocytosis by decreasing the migration of granulocytes into the inflammatory area. • They are commonly used now for treatment of acute attack or to prevent recurrent attacks with other drugs. • ( Except aspirin & paracetamol)

  17. 2. Colchicine

  18. Basyir Bin Kamaruzaman (15)

  19. OVERVIEW

  20. MECHANISM OF ACTIONS

  21. PHAPHARMACOKINETICS PHARMACOKINETICS

  22. THERAPEUTIC USES

  23. Adverse effects • Severe diarrhea ( cause of its restriction in use ) • Chronic use alopecia, bone marrow depression, peripheral neuritis, myopathy.

  24. Acute intoxication ( large doses) • Burning pain in throat • Bloody diarrhea • Shock • Hematuria • C.N.S. depression

  25. Contraindication • pregnancy Precaution • in hepatic , renal problems

  26. 3. Corticosteroids

  27. Chronic gout (long term treatment) 1-Inhibition of uric acid synthesis 2-Increase excretion of uric acid

  28. Treatment of Refractory Gout Mammalian uricase enzyme

  29. Inhibition of uric acid synthesis

  30. Xanthine Oxidase Inhibitors

  31. Mechanism of action

  32. ALLOPURINOL-Pharmacokinetics • Well absorbed orally (80% ) • Metabolized in the liver to oxypurinolwhich is responsible for most of its urate-lowering effect • Given once daily. • Drug & its metabolite excreted through the kidney. • Dose adjustment is needed in renal impairment

  33. Pharmacokinetics

  34. Therapeutic Uses • Treatment of primary hyperuricemia

  35. Hyperuricemia secondary to other conditions such as :

  36. Impaired renal functions.

  37. uric acid stones or nephropathy.

  38. In patients receiving cancer chemotherapy

  39. ALLOPURINOLSIDE EFFECTS &DRUG INTERACTIONS

  40. Side Effects (most common) exacerbation of an acute attack of gout

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