Pharmacology, part 30: Musculoskeletal Medications for Gout

by Cathy Parkes March 30, 2021

In this video

Acute gout attack - Colchicine

  • Indications
  • Mode of action
  • Side effects
  • Patient teaching
  • Tip for remembering

Uricosuric agent - Probenecid

  • Indications
  • Mode of action
  • Side effects
  • Patient teaching
  • What to monitor
  • Tip for remembering

Xanthine oxidase inhibitor - Allopurinol

  • Indications
  • Mode of action
  • Side effects
  • Patient teaching
  • What to monitor
  • Tip for remembering

Full Transcript

Alright. In this video, we are going to wrap up our coverage of musculoskeletal medications. Specifically, I will be covering medications that are used for gout.

So the first medication I want to talk about is a med that is used for an acute gout attack, and that is colchicine.

So colchicine can help reduce the pain and inflammation in an acute gout attack by interfering with the white blood cells' initiation of the inflammatory response in the body.

Side effects can include GI upset as well as thrombocytopenia.

In terms of patient teaching, we want to encourage our patient to increase their fluid intake and also let them know that they should not consume grapefruit juice while taking colchicine.

So the way I remember this medication is that colchicine looks like cool chicken, and my little tip for this is actually what kicked off the whole cool chicken icon and cool chicken craze.

So if a guy, he's got his chicken, and he sees his friend, and his friend's like, "Hey, man. Cool chicken," and the guy is like, "Thanks," but then the chicken pecks the friend's gouty toe. And the guy is like, "Oh, my gouty toe. Your chicken just pecked it." And so that just helps me to remember that when I see cool chicken or colchicine, I think about that chicken pecking somebody's gouty toe, and it helps me to remember that colchicine is used for an acute gout attack.

Alright. Let's now talk about a uricosuric agent which is used to treat chronic gout. This is Probenecid. Probenecid helps to treat hyperuricemia with chronic gout by inhibiting renal reabsorption of uric acid. So it basically helps to improve excretion of that uric acid.

Side effects can include GI upset as well as renal calculi, which is a fancy name for a kidney stone.

So when your patient is on this medication, you want to encourage them to increase their fluid intake to help prevent formation of a kidney stone.

In addition, we're going to want to monitor their uric acid levels as well as their renal function during therapy. In terms of how I remember this, if you look at the drug name, Probenecid, that "-bene-" helps to remind me of benefit, so I think, "Your chronic gout would benefit from Probenecid."

Alright. Let's now talk about a xanthine oxidase inhibitor, which is allopurinol.

So just like with Probenecid, allopurinol helps to treat hyperuricemia with chronic gout.

However, its mode of action is different. So instead of promoting excretion of uric acid, allopurinol helps to inhibit uric acid production in the first place.

In terms of side effects, there are some more serious side effects with this medication. This includes GI upset, a rash, as well as hepatotoxicity, and nephrotoxicity.

So patient teaching. We're going to definitely encourage our patient to increase their fluid intake. We also need to really monitor their liver and renal function during therapy, and we should also let our patient know that it takes about two to six weeks before they see an improvement in symptoms.

In terms of how I remember what this medication is for, when I look at the drug name allopurinol, it makes me think, "Purify and get rid of all of that uric acid." So, hopefully, that's helpful for you.

That wraps up our coverage of gout medications and our coverage of musculoskeletal medications! So next up, I will be talking about endocrine medications. If you have found value in this video, be sure to like and subscribe to us here at Level Up RN, and tell your friends in nursing school and your classmates about our channel as well!


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