Question

Discuss at least three symptoms caused by physiologic changes and consequences of Gout and Osteoarthritis. Discuss the findings for each disorder, comparing and contrasting symptoms, lab findings, and possible etiologies. Discuss how pharmaceutical treatments are designed to alleviate those symptoms. What are the risks and benefits of these treatments? What are potential drug interactions with these medications?

Answer 1

Gout

Gout is caused by over uric acid production under excretion of uric acid by kidney or intake foods containing purine which are metabolized to uric acid by the body. Excessive uric acid build up and are deposited in joints and other connective tissues, causing severe inflammation . When an attack of gout occurs the patient has severe pain in one or more small joints usually the great toe. The inflammations may last for several days and resolve with or without treatment. Urate deposits may appear under the skin or in the kidney or urinary system, causing stone formation.

Etiology

It is caused by an inherited problem with purine metabolism. Uric acid production is greater than the kidneys ability to excrete it. Family history is also part of cause of gout. Stress, alcohol, illness, trauma, dieting, or certain medications are some of the reason.

Sign and symptons

Severely inflammed joints due to uric acid crystals. Joint may be swollen, red, hot, and usually too painful to be touched.

Renal stone also is formed in the case of chronic gout.

Diagnostic test

It is based on elevated serum uric acid level.

Joint fluid aspirations analtsis can identify uric acid crystals in the synovial fluid.

Medication

Drug therapy -physician prescribes NSAID to reduce inflammation due to crystals.

Allopurinol is the preferred drug for chronic gout.

Probenecid may also may also be used to increase renal excretion.

Diet

The patient should avoid aspirin and diuretics because they can teigger an attack. Daily intake of water is important to prevent kidney stone.

Osteoarthritis

This is also a connetive tissue disorder, it is also inflammation of joints. Osteoarthritis take place when articular cartilage and bone ends of jonts slowly deteriorate. Joint space may narrow, bone spurs develop.

Reasons

No exact cause is identified but some facotors can become risk factors of OA.

Aging, obesity and physical activities which produce mechanical stresson joints.

Patient with secondary OA develop joint degeneration as result of trauma, sepsis, certain metabolic diseases.

Sign and symptoms

Joint pain and stiffness

Pain increases with activity decreses while on rest. Redness, warmth, swelling.

In some case there is chance of low-grade fewer and weight loss.

Osteoarthritis patient have a bony nodes on the joints of their fingers.

Diagnostic Tests

X-ray, CT scan, MRI scan may be used to diagnose various joint involvement. Analysis of synovial fluid can help diagnose IA.

Medications

Drug therapy- Non-steroid anti inflammatory drugs(NSAID)

Corticosteroid -Reduce inflammation and swelling

Antirheumatic drugs

This medicine used for rheumatoid arthritis.