{"id":434,"date":"2019-12-01T20:17:12","date_gmt":"2019-12-01T20:17:12","guid":{"rendered":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/chapter\/10-9-antigout\/"},"modified":"2025-01-16T22:28:52","modified_gmt":"2025-01-16T22:28:52","slug":"10-9-antigout","status":"publish","type":"chapter","link":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/chapter\/10-9-antigout\/","title":{"raw":"10.9 Antigout Medications","rendered":"10.9 Antigout Medications"},"content":{"raw":"
\n\nAntigout medications are used to treat gout, a musculoskeletal disorder. Allopurinol is commonly used to prevent gout from recurring. Colchicine, classified as anti-inflammatory medication, is used to prevent and treat acute gout flares.\n

<\/a>Allopurinol<\/h2>\nMechanism of Action: <\/strong>Allopurinol blocks the production of uric acid by inhibiting the action of xanthine oxidase.\n\nIndications: <\/strong>Allopurinol is used for the prevention of gouty arthritis and for the treatment of secondary hyperuricemia.\n\nNursing Considerations: <\/strong>Allopurinol is safe for all ages. For clients with renal impairment, the dose will be reduced.\n\nSide Effects\/Adverse Effects: <\/strong>Adverse effects include hypotension, flushing, drowsiness, nausea and vomiting, diarrhea, hepatitis, renal failure, drug rash with eosinophilia and systemic symptoms (DRESS) syndrome, or drug hypersensitivity syndrome.[footnote]Cleveland Clinic. (2017, January 26). Acute vs. chronic pain.<\/em> https:\/\/my.clevelandclinic.org\/health\/articles\/12051-acute-vs-chronic-pain<\/a>[\/footnote]<\/sup>\n\nHealth Teaching & Health Promotion: <\/strong>The medication should be taken as directed. An alkaline diet may be ordered for the client, and they may be advised to increase fluid intake to prevent kidney stone formation. The medication may cause dizziness or drowsiness. Clients who consume large amounts of alcohol may increase uric acid concentrations and decrease the effectiveness of the medication. If a client develops a rash or blood in the urine, these new symptoms should be reported promptly to the health care provider.[footnote]uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a>[\/footnote]<\/sup>\n

Colchicine<\/h2>\nMechanism of Action: <\/strong>Colchicine has primarily anti-inflammatory properties.\n\nIndications:\u00a0<\/strong>Colchicine is indicated for prophylaxis and the treatment of acute gout flares.\n\nNursing Considerations: <\/strong>The recommended dosage of colchicine depends on the client\u2019s age, renal function, hepatic function, and use of co-administered drugs. Colchicine is not an analgesic medication and should not be used to treat pain from other causes. It is administered orally without regard to meals.\n\nSide Effects\/Adverse Effects: <\/strong>The most commonly reported side effect of colchicine is diarrhea. Life-threatening and fatal drug interactions have been reported in clients treated with colchicine given with P-gp and strong CYP3A4 inhibitors. Myelosuppression, leukopenia, granulocytopenia, thrombocytopenia, pancytopenia, and aplastic anemia have been reported with colchicine used in therapeutic doses. Colchicine-induced neuromuscular toxicity and rhabdomyolysis have been reported in elderly clients and those with renal dysfunction.\n\nHealth Teaching & Health Promotion: <\/strong>Clients should be instructed to take colchicine as prescribed, even if they are feeling better. Clients should not alter the dose or discontinue treatment without consulting with their provider. They should report to their health care provider all of the current medications they are taking and check before starting any new medications, particularly antibiotics, as well as nonprescription medication or herbal products. Grapefruit and grapefruit juice may also interact and should not be consumed during colchicine treatment. Clients should be informed to seek medication evaluation immediately if muscle pain or weakness, tingling, or numbness in fingers or toes occur.\n\nNow let\u2019s take a closer look at the medication grid on antigout medication in Table 10.9.[footnote]This work is a derivative of DailyMed<\/a> by U.S. National Library of Medicine<\/a> in the Public Domain.<\/a>[\/footnote]<\/sup>\n\nTable 10.9 Antigout Medication Grid\n\n\n\n\n\n
Class\/<\/strong>Subclass<\/strong><\/th>\nPrototype\/G<\/strong>eneric<\/strong><\/th>\nNursing <\/strong>Considerations<\/strong><\/th>\nTherapeutic Effects<\/strong><\/th>\nSide\/Adverse Effects<\/strong><\/th>\n<\/tr>\n
allopurinol\nMay be given with milk or meals to decrease stomach upset\n\nGive with plenty of water\n\nMay be crushed\n\nMonitor intake and output\n\nMonitor hematologic, renal, and liver functions before and during therapy\n\nIf rash occurs, notify health care provider<\/td>\nPrevention of gout\n\nTreatment of secondary hyperuricemia<\/td>\nHypotension\n\nFlushing\n\nHypertension\n\nDrowsiness\n\nNausea and vomiting\n\nDiarrhea\n\nHepatitis\n\nRash\n\nRenal failure<\/td>\n<\/arrow><\/th><\/tr>\n
Antigout Agent<\/strong><\/th>\ncolchicine<\/a><\/td>\nMonitor hematologic, renal, and liver functions<\/td>\nTreatment of acute gout flares<\/td>\nDiarrhea\n\nNeuromuscular toxicity\n\nRhabdomyolysis\n\nMyelosuppression, leukopenia, granulocytopenia, thrombocytopenia, pancytopenia, and aplastic anemia<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n \n\n<\/div>","rendered":"
\n

Antigout medications are used to treat gout, a musculoskeletal disorder. Allopurinol is commonly used to prevent gout from recurring. Colchicine, classified as anti-inflammatory medication, is used to prevent and treat acute gout flares.<\/p>\n

<\/a>Allopurinol<\/h2>\n

Mechanism of Action: <\/strong>Allopurinol blocks the production of uric acid by inhibiting the action of xanthine oxidase.<\/p>\n

Indications: <\/strong>Allopurinol is used for the prevention of gouty arthritis and for the treatment of secondary hyperuricemia.<\/p>\n

Nursing Considerations: <\/strong>Allopurinol is safe for all ages. For clients with renal impairment, the dose will be reduced.<\/p>\n

Side Effects\/Adverse Effects: <\/strong>Adverse effects include hypotension, flushing, drowsiness, nausea and vomiting, diarrhea, hepatitis, renal failure, drug rash with eosinophilia and systemic symptoms (DRESS) syndrome, or drug hypersensitivity syndrome.[1]<\/sup><\/a><\/sup><\/p>\n

Health Teaching & Health Promotion: <\/strong>The medication should be taken as directed. An alkaline diet may be ordered for the client, and they may be advised to increase fluid intake to prevent kidney stone formation. The medication may cause dizziness or drowsiness. Clients who consume large amounts of alcohol may increase uric acid concentrations and decrease the effectiveness of the medication. If a client develops a rash or blood in the urine, these new symptoms should be reported promptly to the health care provider.[2]<\/sup><\/a><\/sup><\/p>\n

Colchicine<\/h2>\n

Mechanism of Action: <\/strong>Colchicine has primarily anti-inflammatory properties.<\/p>\n

Indications:\u00a0<\/strong>Colchicine is indicated for prophylaxis and the treatment of acute gout flares.<\/p>\n

Nursing Considerations: <\/strong>The recommended dosage of colchicine depends on the client\u2019s age, renal function, hepatic function, and use of co-administered drugs. Colchicine is not an analgesic medication and should not be used to treat pain from other causes. It is administered orally without regard to meals.<\/p>\n

Side Effects\/Adverse Effects: <\/strong>The most commonly reported side effect of colchicine is diarrhea. Life-threatening and fatal drug interactions have been reported in clients treated with colchicine given with P-gp and strong CYP3A4 inhibitors. Myelosuppression, leukopenia, granulocytopenia, thrombocytopenia, pancytopenia, and aplastic anemia have been reported with colchicine used in therapeutic doses. Colchicine-induced neuromuscular toxicity and rhabdomyolysis have been reported in elderly clients and those with renal dysfunction.<\/p>\n

Health Teaching & Health Promotion: <\/strong>Clients should be instructed to take colchicine as prescribed, even if they are feeling better. Clients should not alter the dose or discontinue treatment without consulting with their provider. They should report to their health care provider all of the current medications they are taking and check before starting any new medications, particularly antibiotics, as well as nonprescription medication or herbal products. Grapefruit and grapefruit juice may also interact and should not be consumed during colchicine treatment. Clients should be informed to seek medication evaluation immediately if muscle pain or weakness, tingling, or numbness in fingers or toes occur.<\/p>\n

Now let\u2019s take a closer look at the medication grid on antigout medication in Table 10.9.[3]<\/sup><\/a><\/sup><\/p>\n

Table 10.9 Antigout Medication Grid<\/p>\n\n\n\n\n\n
Class\/<\/strong>Subclass<\/strong><\/th>\nPrototype\/G<\/strong>eneric<\/strong><\/th>\nNursing <\/strong>Considerations<\/strong><\/th>\nTherapeutic Effects<\/strong><\/th>\nSide\/Adverse Effects<\/strong><\/th>\n<\/tr>\n
allopurinol\n<\/th>\nMay be given with milk or meals to decrease stomach upset<\/p>\n

Give with plenty of water<\/p>\n

May be crushed<\/p>\n

Monitor intake and output<\/p>\n

Monitor hematologic, renal, and liver functions before and during therapy<\/p>\n

If rash occurs, notify health care provider<\/td>\n

Prevention of gout<\/p>\n

Treatment of secondary hyperuricemia<\/td>\n

Hypotension<\/p>\n

Flushing<\/p>\n

Hypertension<\/p>\n

Drowsiness<\/p>\n

Nausea and vomiting<\/p>\n

Diarrhea<\/p>\n

Hepatitis<\/p>\n

Rash<\/p>\n

Renal failure<\/td>\n<\/tr>\n

Antigout Agent<\/strong><\/th>\ncolchicine<\/a><\/td>\nMonitor hematologic, renal, and liver functions<\/td>\nTreatment of acute gout flares<\/td>\nDiarrhea<\/p>\n

Neuromuscular toxicity<\/p>\n

Rhabdomyolysis<\/p>\n

Myelosuppression, leukopenia, granulocytopenia, thrombocytopenia, pancytopenia, and aplastic anemia<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n<\/div>\n

  1. Cleveland Clinic. (2017, January 26). Acute vs. chronic pain.<\/em> https:\/\/my.clevelandclinic.org\/health\/articles\/12051-acute-vs-chronic-pain<\/a> ↵<\/a><\/li>
  2. uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a> ↵<\/a><\/li>
  3. This work is a derivative of DailyMed<\/a> by U.S. National Library of Medicine<\/a> in the Public Domain.<\/a> ↵<\/a><\/li><\/ol><\/div>","protected":false},"author":83,"menu_order":9,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[48],"contributor":[],"license":[],"class_list":["post-434","chapter","type-chapter","status-publish","hentry","chapter-type-numberless"],"part":410,"_links":{"self":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/434","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/users\/83"}],"version-history":[{"count":1,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/434\/revisions"}],"predecessor-version":[{"id":435,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/434\/revisions\/435"}],"part":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/parts\/410"}],"metadata":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/434\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/media?parent=434"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapter-type?post=434"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/contributor?post=434"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/license?post=434"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}