Pathophysiology of gout
- overproduction of uric acid
- hyperuricaemia occurs
- causes urate crystals to form and deposit in the joints
- inflammatory cells are activated
- cytokines are then released which causes more inflammatory mediators
- causes an acidic environment meaning more urate cystals
Risk factors of gout
Alcohol
Hyperuricaemia
Age
Gender
Medication
What should not be given during gout?
Aspirin
Diuretics
Cyclosporine (medication for rheumatoid arthritis, psoriasis)
What is the pharmacology of colchicine and allupurinol for gout
Colchicine inhibits the proliferation only anti-inflammatory pathways
Allopurinol inhibits xanithine oxidase which converts hypoxanthine to xanithine a component in uric acid
Lifestyle advice for gout (acute attack and prophylaxis )
Acute attack
-Ice to reduce inflammation
- R.E.S.T
Prophylaxis
-weight loss
-avoid dehydration
-Alcohol
How does bendeoflunethiazide cause gout
It can increase the levels of uric acid
when should a follow up be considered?
4-6 weeks after a flare up
when to refer gout
if septic arthritis is suspected
