An acute episode of gout is treated with a nonsteroidal anti-inflammatory drug or colchicine. what treatment for prevention of further attacks would the nurse expect to be prescribed for a client?
Question: An acute episode of gout is treated with a nonsteroidal anti-inflammatory drug or colchicine. what treatment for prevention of further attacks would the nurse expect to be prescribed for a client?
Gout is a type of arthritis that causes sudden and severe pain, swelling, and inflammation in the joints. It is caused by high levels of uric acid in the blood, which can form crystals in the joints and trigger inflammation. Gout usually affects the big toe, but it can also affect other joints such as the ankle, knee, wrist, or elbow.
An acute episode of gout is treated with a nonsteroidal anti-inflammatory drug (NSAID) or colchicine. These medications can reduce the pain and inflammation of the gout attack, but they do not lower the uric acid level or prevent future attacks. Therefore, the nurse would expect to be prescribed a medication that can lower the uric acid level and prevent further attacks for a client with gout.
There are two main types of medications that can lower the uric acid level and prevent further attacks: uricosuric agents and xanthine oxidase inhibitors. Uricosuric agents increase the excretion of uric acid by the kidneys, while xanthine oxidase inhibitors decrease the production of uric acid by the liver. The nurse would need to assess the client's renal function, liver function, and medical history before recommending a specific medication.
Some examples of uricosuric agents are probenecid and sulfinpyrazone. Some examples of xanthine oxidase inhibitors are allopurinol and febuxostat. These medications need to be taken regularly and monitored for side effects such as rash, nausea, diarrhea, headache, or liver damage. They also need to be started at a low dose and gradually increased to avoid triggering a gout attack.
The nurse would also educate the client about lifestyle changes that can help prevent gout attacks, such as drinking plenty of water, avoiding alcohol and purine-rich foods (such as red meat, seafood, organ meats, and beer), losing weight if overweight, and exercising regularly.
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