Pharmacology Module 4 & 5: Gout and Lithium

Study Notes

Gout and Treatments

Uric acid crystals accumulate in joints causing inflammation.
Allopurinol lowers hyperuricemia associated with severe gout.
- Adverse effects include rash and Stevens-Johnson syndrome (SJS).
- May take 1-3 weeks for uric acid levels to decrease.

Mental Health Medications

Lithium: Used for bipolar disorder; acts as a mood stabilizer, mimicking sodium in the body.
- Narrow therapeutic window; interacts with numerous medications.
- Maximum effect typically achieved in 4-8 weeks.
Tricyclic Antidepressants (TCAs): Second-line treatment for depression; takes 4-8 weeks for full effect.
Diazepam: A benzodiazepine; Humira is a reversal agent.
Antipsychotics: Risperidone is notable for having milder side effects.

Pain Management Medications

Ibuprofen: NSAID for mild to moderate pain, fever, and inflammation.
- Used with caution in patients with kidney disease and can increase GI events.
Ketorolac: NSAID (Sprix, Toradol) used similarly to ibuprofen; caution against polypharmacy with NSAIDs.
Acetaminophen (Tylenol): Alternative for those who cannot take NSAIDs.
- Adverse effects include hypotension and constipation; recommended for patients with a history of gastric ulcers.
Opioids: Prescribed for severe pain, persistent cough, and diarrhea.
- Examples: morphine, oxycodone, fentanyl, methadone; high risk for dependency with rapid onset of effects.

Opioid Overdose Management

Naloxone: Opioid receptor antagonist used for treating acute opioid overdose and respiratory depression.

Antibacterial Medications

Vancomycin: Effective against MRSA infections; requires close monitoring of renal function and urine output.
- Adverse effect includes oliguria.
Sulfamethoxazole-Trimethoprim (Bactrim): Used for uncomplicated urinary tract infections (UTIs), given over a 3-day regimen.
- Crosses placental barrier; caution advised for pregnant women.
Gentamicin: Prototype aminoglycoside antibiotic; major risks include neurotoxicity and ototoxicity.
Metronidazole: Antiprotozoan; contraindicated with alcohol and may increase warfarin levels.
- Common side effects include GI upset and a metallic taste; harmful to pregnant women.

Bactericidal vs. Bacteriostatic Medications

Sulfa Methoxazole: Bacteriostatic; inhibits bacterial replication rather than directly killing bacteria.
Macrolide Antibiotics: Inhibit protein synthesis; can cause oral candidiasis if not adequately rinsed.

Specific Antifungal and Antibacterial Treatments

Nystatin (Nystop): Superficial antifungal treatment for yeast infections; available in various forms.
- May decrease absorption; no food restrictions during administration.
Ciprofloxacin: Fluoroquinolone that poses a risk for tendon rupture (black box warning); used to treat anthrax and other serious infections.
Fluoroquinolones: Target atypical pathogens; effective against bacterial bronchitis and pneumonia.

Description

Explore the key concepts of gout treatment and lithium use in bipolar disorder with this quiz. Understand the roles of allopurinol in reducing uric acid levels and the implications of lithium as a mood stabilizer. Test your knowledge on adverse effects and therapeutic windows related to these medications.