30 Questions
What is the first-line management for acute gout attacks?
Colchicine
What lifestyle changes are recommended for management between gout attacks?
Avoiding purine-rich foods
Which medication may be indicated in patients with frequent acute gout attacks?
Probenecid
What is the role of xanthine oxidase inhibitors in gout management?
Lowering uric acid levels
In patients with refractory chronic gout, which newer agent has been shown to be effective in lowering uric acid levels?
Pegloticase
What is the suggested role of anakinra in gout management?
Management of acute gout
When should uric acid lowering therapy be considered in gout management?
After the acute inflammatory process has subsided
What is the primary mechanism of action of corticosteroids in gout management?
Anti-inflammatory effects
What do uricosuric agents such as probenecid do in gout management?
Correct hyperuricemia and dissolve deposited urate
What factors are specific treatment decisions based on in gout management?
Serum uric acid level, 24-hour urinary uric acid excretion, and renal function
What is the normal serum uric acid level?
3.0 to 7.0 mg/dL
Which adverse effect is a risk factor with the use of allopurinol?
Hepatotoxicity
What are the CNS adverse effects of allopurinol?
Drowsiness, headache, and vertigo
Which medication increases the risk of uricosuric-associated toxicity when combined with allopurinol?
Probenecid
What is the dosage adjustment of allopurinol based on in patients with renal impairment?
Creatinine clearance
What should the nurse assess for in patients taking allopurinol?
Decreased pain and inflammation
What is a contraindication for taking allopurinol?
History of idiopathic hemochromatosis
What is the most common GI adverse effect of allopurinol?
Nausea and vomiting
Which medication, when combined with allopurinol, increases the risk of developing a rash?
Ampicillin
What should the nurse assess for to monitor liver function in patients taking allopurinol?
Alanine aminotransferase levels
What is the half-life of colchicine?
26 to 31 hours
How is colchicine primarily eliminated from the body?
Feces
What is the initial recommended dose of allopurinol for geriatric patients?
100 mg/d
What is the main mechanism of action of allopurinol?
Xanthine oxidase inhibition
What is a contraindication for the use of colchicine?
Known hypersensitivity
What are the adverse effects of colchicine?
GI issues, hematologic effects, hepatotoxicity
How should colchicine be administered to reduce gastric distress?
With food
What should be assessed by the nurse to evaluate the therapeutic effects of colchicine?
Decreased pain, swelling, and inflammation of affected joints
What is the peak of action of allopurinol?
2 to 6 hours
For which condition is allopurinol not indicated?
Arthritis
Study Notes
Colchicine and Allopurinol in Gout Treatment
- Colchicine is used to treat and prevent gout, with a slow onset of action and a half-life of 26 to 31 hours.
- It is primarily eliminated in the feces and is administered cautiously in older adults, with a reduced dosage for those 70 years and older.
- For patients with renal impairment, a regular dosage is administered for mild to moderate impairment, but for creatinine clearance less than 30 mL/min, a reduced dosage is necessary.
- Colchicine should be administered cautiously in patients with hepatic impairment, and adverse effects include GI issues, hematologic effects, and hepatotoxicity.
- It is contraindicated in patients with known hypersensitivity and should not be given concurrently with certain medications or in pregnancy.
- Colchicine can result in toxicity and severe adverse effects when combined with specific medications, and it should be administered with food to reduce gastric distress.
- Therapeutic effects of colchicine occur within 24 to 48 hours after oral administration, with the nurse assessing for decreased pain, swelling, and inflammation of affected joints.
- Adverse effects of colchicine include severe GI issues, numbness, tingling, muscle weakness, bone marrow depression, and altered liver enzymes.
- Allopurinol is a xanthine oxidase inhibitor used to reduce serum uric acid levels in gout treatment, with a peak of action at 2 to 6 hours and a half-life of 1 to 3 hours.
- It inhibits the enzyme responsible for the conversion of purines to uric acid, reducing uric acid production and the symptoms of gout.
- Allopurinol is administered for the management of primary and secondary gout, acute and chronic tophaceous gout, and other indications such as leukemia and lymphoma.
- In geriatric patients, the initial dose of allopurinol is 100 mg/d, which can be increased until the desired uric acid level is obtained, with a reduced dosage for diminished renal function.
"Colchicine and Allopurinol in Gout Treatment" Quiz Test your knowledge of the pharmacology and administration of colchicine and allopurinol in the treatment of gout. Assess your understanding of dosage considerations, contraindications, therapeutic effects, and potential adverse reactions associated with these medications.
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