A male patient in his 50s has just been diagnosed with hyperuricemia. He has had multiple flare-ups of his first metatarsophalangeal joint pain and swelling
The pain is so severe that he cannot sleep with any covers/sheets over his feet at night. The nurse should anticipate that the patient will likely be prescribed: Select all that apply.
A)
Tylenol (acetaminophen) for the pain.
B)
allopurinol (Zyloprim) to decrease uric acid levels.
C)
calcium carbonate used to increase the intake of calcium.
D)
Anturane (sulfinpyrazone) to increase excretion of urate.
E)
sevelamer (Renagel) to reduce the absorption of phosphate.
Ans:
B, D
Feedback:
Treatment of hyperuricemia is aimed at maintaining normal uric acid levels and is lifelong. One method is to reduce hyperuricemia through the use of allopurinol. Allopurinol inhibits xanthine oxidase, an enzyme needed for the conversion of hypoxanthine to xanthine and xanthine to uric acid as does a newer medication, Febuxostat. The uricosuric drugs (sulfinpyrazone) prevent tubular reabsorption of urate and increase its excretion in the urine. NSAIDs, not Tylenol, are usually prescribed for the pain. Calcium does not play a factor in gout. Sevelamer (Renagel), to reduce the absorption of Phosphate, is primarily used in renal failure patients.
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