2nd Sessional Practical Examination December 2023 Roll no-210429800020

Case Study on
Gout
Presented to:- Presented by:-
Dr. Rohit Bangwal Satyam Saini
Assistant Professor, Pharm PharmD 3rd Year
D Department of Pharmacy Subject:- Pharmacotherapeutics
SDBIT, Dehradun, UK II SDBIT, Dehradun, UK
Date Of Submission:
28/12/2023
Introduction
• Gout is a metabolic disorder of purine metabolism, characteroised by intermittent
attacks of acute pain, swelling and inflammation.
• Gout can be extremely painful and incapacitating, but is extremely treatable
in almost all patients.
• It is most common in the big toe, and is also common in the midfoot, ankle,
and knee.
• It always preceded by hyperuricemia due to excessive amount of uric
acid production of decreased excretion.
• Gout is a painful form of arthritis. When your body has extra uric acid,
sharp crystals can form in your joints (usually your big toe)
 Subjective
•Data:
Patient Name: Mrs.Jessica
• Gender: Female
• Age: 55 years
• Weight: 94 kg
• Department: Rheumatology
• Ward: Female Medical ward
• Date of Admission:
22/12/2023
• Date of Discharge: 31/12/2023
Objectiv
e• Pain,swelling and redness in her right great toe.
• Woke up in night with extreme excruciating pain in toe, by morning
her toe was dark red and warm.

• Same episode was faced by her 3 years ago.

• Stiffness in the joints.

 Vitals / Lab
•Data:
BP: 120/80 mmHg
• GC: Fair
• RS: NVBS
• PR: 80Bpm
• CVS: S1 S2 Present
• P/A: Soft
Lab
Investigation:
PARAMETERS OBSERVED VALUES NORMAL VALUES

TC(WBC) 6000 cells/cumm 4000-11000 cells/cumm

Hb 12gm/dl 13.0-18.0 gm/dL

Platelet 2.0 lakhs/cumm 1.5-4.0 lakhs/cumm

Neutrophills 57% 40-70%

Monocytes 03% 2-10%

Uric Acid 8.0mg/dl 2.5-7.5mg/dl

S.Creatinine 3mg/dl 0.6-1.2mg/dl
Assesment
:Provisional diagnosis: Foot pain , effusion of foot pain.
Based on the subjective and objective finding the physician diagnosed
that the patient was suffering from Gout.
Goals of
Treatment
⚫ The three general goal of therapy in the management of GOUT
recommended by British Society of Rheumatology.
⚫ Management of the acute painful attack.
⚫ Recommendations to change diet , lifestyle modifications and
implementation non pharmacological modilities.
⚫ Management of recurrent or chronic gout.
Assesment of current
therapy
Drug
Interaction
Drug-Drug Interactions
• Ketoprofen X naproxen

Effect: Both increase anticoagulation & serum potassium.

Management: By changing frequency or using alernative drugs.

Adverse Drug
Effect :
• Hypersenstivity
• Muscle pain
• Rashes
• Fever
• Gastric irritation
• Headache
• Nausea
• Dizziness
• Liver damage
• Insomnia
• Nervousness
Patient
Counselling:
• Keep a supply of NSAIDS and take it as soon as first symptoms appear.
• Reduce weight.
• Reduce alcohol consumption.
• Avoid daily intake of organ meat, especially liver.
• Drink plenty of water preferably 10-12 glasses per day.
• Regular follow-up at 3-month intervals.
• Report if acute attacks are frequent, not responding to NSAIDS, or if systemic features develop
• Should avoid purine-rich foods (such as beer, some fish, and spinach), and reduce their
total calorie intake and cholesterol intake.
• Pain area should be rested and use of ice may help.
• If dose is missed do not take double dose.