Gout and Hyperuricemia By RS Objectives Definition Epidemiology Etiology Pathophysiology overproduction of uric acid Pathophysiology underexcretion of uric acid majority of patients 80 to 90 with gout have a ID: 297755
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Slide1
Farmakoterapi Sistem Organ III: Gout and Hyperuricemia
By:
RSSlide2
ObjectivesSlide3
DefinitionSlide4
EpidemiologySlide5
EtiologySlide6
Pathophysiology:overproduction of uric acidSlide7
Pathophysiology:underexcretion of uric acid
majority of patients (80% to 90%) with gout have a
relative
decrease in the renal
excretion of uric acid
Uric acid is eliminated in two ways
: 2/3 via renal & 1/3 via GI tractSlide8Slide9
Predisposing FactorsSlide10
Clinical PresentationSlide11
Clinical PresentationSlide12
Clinical ManifestationSlide13
Diagnostic TestSlide14
American College of Rheumatology Criteria for theClinical Diagnosis of
Gout
The combination of crystals, tophi, and/or six or more criteria is highly suggestive of gout.
Data from Wallace SL, Robinson H,
Masi
AT, et al. Preliminary criteria for the classification of the
acute arthritis of primary gout. Arthritis Rheum 1977; 20:895–900Slide15
Differential Diagnosis
RA
GOUT
CPPD
OASlide16
Treatment GoalsSlide17
Non-pharmacologic TreatmentSlide18
Treatment Algorithm for Acute Gouty ArthritisSlide19
Acute Gout TreatmentSlide20
NSAIDsSlide21
ColchicineSlide22
Others Acute Treatments AgentsSlide23
Prophylaxis TreatmentSlide24
Xanthine Oxidase InhibitorSlide25
Uricosuric drugsSlide26
Miscellaneous AgentsSlide27
ComplicationsSlide28
PHARMACOECONOMICSlide29
EVALUATION OF THERAPEUTIC OUTCOMESSlide30
Questions....Slide31
References
Klippel
,
JH.Primer
on Rheumatic Diseases. 12
th
ed.
Arthitis
Foundation 2001; 307-323.
Schumacher HR, Chen LX. Newer Therapeutic Approaches: Gout. Rheumatic Disease Clinics of North America 2006;32.
Pittman, JR,
Bross
, MH. Diagnosis and Management of Gout. American Family Physician 1999;59
Monu
JU, Pope TL. Gout: a clinical and radiologic review. Radiologic Clinics of North America. 2004;42
Goldman. Cecil Textbook of Medicine. 22
nd
ed. W.B. Saunders Company 2004;
Shen
S, Wolfe R. Gout. Emergency Medicine Clinical Reviews. 2004
Wells, B.,
Dipiro
, J.T.,
Schwinghammer
, T.L.,
Dipiro
, C.V., 2009. Pharmacotherapy Handbook. 7
th
Ed.
Mc
Graw
Hill Companies. Inc. New
YorkSlide32