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Gout Overview Gout is a disease characterized by an abnormal metabolism of uric acid, resulting in an excess of uric acid in the tissues

and blood. People with gout either produce too much uric acid, or more commonly, their bodies have a problem in removing it. There are a number of possible consequences of this build-up of uric acid in the body, including acute and chronic gouty arthritis, kidney stones, and local deposits of uric acid (tophi) in the skin and other tissues. Gout may occur alone (primary gout) or may be associated with other medical conditions or medications (secondary gout).

The prevalence of gout appears to be increasing. It is currently Gout Overview estimated to be affecting over 6 million Americans.

Gout is a disease characterized by an abnormal metabolism of uric acid, cause of a sudden excess of painful, hot, Gouty arthritis is a common resulting in an onset of a uric acidswollen joint, particularly in the foot atwithbig toe.either red, in the tissues and blood. People the gout Gouty arthritis istoo much the most common cause of inflammatory produce reportedly uric acid, or more commonly, their arthritis have aover the age of 40. It is definitively diagnosed by bodies in men problem in removing it. There are a number detecting uric acid (monosodium urate) crystals in an aspirated of possible consequences of this build-up of uric acid in sample of the joint fluid. These uric acid crystals can accumulate in the joint and tissues around the joint over years, intermittently the body, including acute and chronic gouty arthritis, kidneyof acute inflammation. Repeated "attacks" triggering repeated bouts stones, and local deposits of uric acid (tophi) in or skin and other tissues. Gout lead occur of gouty arthritis,the"flares," can damage the joint andmay to chronic(primaryFortunately, while gout is a progressive disease, alone arthritis. gout) or may be associated with other there are effective medications to treat gout. medical conditions or medications (secondary gout).

> overindulgence in alcohol and red meats, > trauma, > starvation and dehydration, > chemotherapy, > Medications: diuretics and some other antihypertensive medications, aspirin (Bayer, Ecotrin), nicotinic acid (B-3-50, B3-500-Gr, Niacin SR, Niacor, Niaspan ER, Slo-Niacin), cyclosporin A,

Yes, the client’s minor accident contributed to the precipitation of an acute gout attack. As stated in the book one of the factors that may precipitate gout attack is INJURY including the following: dehydration, fever, heavy eating, heavy drinking of alcohol, and recent surgery, obesity, weight gain, high blood pressure, abnormal kidney function, and certain medications.

Uric acid crystals are the underlying problem causing gout pain and inflammation. When there is too much uric acid being produced in the body someone fit will form hard microscopic crystals which build up in joint areas. They are very sharp, like needles or small pieces of glass. Body will react to these crystals as foreign material and attempt to remove them. This is what actually causes the pain and swelling, rather than the crystals themselves. To stop a gout attack, doctor can give a shot of corticosteroids, or prescribe a large daily dose of one or more medicines. To ease the pain during a gout attack, rest the joint that hurts. Taking ibuprofen or another antiinflammatory medicine can also help you feel better. But don't take aspirin. It can make gout worse by raising the uric acid level in the blood.

Paying attention to what you eat may help you manage your gout. Avoid regular daily intake of meat, seafood, and alcohol (especially beer). Drink plenty of water and other fluids. Cut down on proteins that come from red meat, change to low fat dairy products, consume healthy carbs, and avoid both breads and alcohol products that contain brewer’s yeast.

1. Give pain medication as needed especially during

acute attacks. 2. Apply cold packs to inflamed joints to ease discomfort and reduce swelling. 3. Administer anti-inflammatory medication and other drugs, as ordered. 4. To promote sleep, administer pain medication at times that allow maximum rest. 5. Encourage bed rest, but use a bed cradle to keep bed linens off sensitive, in inflamed joints. 6. Encourage the patient to perform techniques that promote rest and relaxation.

7. Provide nutritious diet. Avoid purine rich foods. 8. Before and after surgery, administer colchicines to help prevent gout attacks as ordered. 9. Urge the patient to perform as much self-care as his immobility and pain allow. 10. Urge the patient to drink plenty if fluids 2 liters per day to prevent renal calculi. 11. Discuss the principles of gradual weight reduction with an obese patient. 12. Urge the patient to control hypertension, especially if he has tophaceous renal deposits. 13. Provide emotional support during diagnostic test and procedures.

Colchicine alters the way your body responds to uric acid crystals. Too much uric acid in the body is what leads to the symptoms of gout (swelling and pain).

Probenecid reduces the amount of uric acid in your body by causing it to be passed in your urine.
The colchicine and probenecid combination is used to prevent gout attacks. This medication will not cure gout and it will not stop a gout attack that has already started. Thus this may be a logical therapy to control client’s pain.

Aspirin products may affect the way the body responds to probenecid by further increasing the uric acid that’s why the aspirin prescribed to the patient is questionable. The aspirin should be discontinued and should be replace by NSAID.