Case study on Gout , It is virtual data of Patient.

1. Case Study on Gout
Presented to:-
Dr. Rohit Bangwal
Assistant Professor, Pharm D
Department of Pharmacy
SDBIT, Dehradun, UK
Presented by:-
Satyam Saini
PharmD 3rd Year
Subject:- Pharmacotherapeutics II
SDBIT, Dehradun, UK
2nd Sessional Practical Examination December 2023 Roll no-210429800020
Date Of Submission: 28/12/2023

2. Introduction
• Gout is a metabolic disorder of purine metabolism, characteroised by intermittent
attacks of acute pain, swelling and inflammation.
• Gout can be extremely painful and incapacitating, but is extremely treatable in
almost all patients.
• It is most common in the big toe, and is also common in the midfoot, ankle, and
knee.
• It always preceded by hyperuricemia due to excessive amount of uric acid
production of decreased excretion.
• Gout is a painful form of arthritis. When your body has extra uric acid, sharp
crystals can form in your joints (usually your big toe)

3. Subjective Data:
• Patient Name: Mrs.Jessica
• Gender: Female
• Age: 55 years
• Weight: 94 kg
• Department: Rheumatology
• Ward: Female Medical ward
• Date ofAdmission: 22/12/2023
• Date of Discharge: 31/12/2023

4. Objectiv
e
• Pain,swelling and redness in her right great toe.
• Woke up in night with extreme excruciating pain in toe, by morning
her toe was dark red and warm.
• Same episode was faced by her 3 years ago.
• Stiffness in the joints.

5. Vitals / Lab Data:
• BP: 120/80 mmHg
• GC: Fair
• RS: NVBS
• PR: 80Bpm
• CVS: S1 S2 Present
• P/A: Soft

6. Lab Investigation:
PARAMETERS OBSERVED VALUES NORMAL VALUES
TC(WBC) 6000 cells/cumm 4000-11000 cells/cumm
Hb 12gm/dl 13.0-18.0 gm/dL
Platelet 2.0 lakhs/cumm 1.5-4.0 lakhs/cumm
Neutrophills 57% 40-70%
Monocytes 03% 2-10%
Uric Acid 8.0mg/dl 2.5-7.5mg/dl
S.Creatinine 3mg/dl 0.6-1.2mg/dl

7. Assesment:
Provisional diagnosis: Foot pain , effusion of foot pain.
Based on the subjective and objective finding the physician diagnosed that
the patient was suffering from Gout.

8. Goals of Treatment
 The three general goal of therapy in the management of GOUT
recommended by British Society of Rheumatology.
 Management of the acute painful attack.
 Recommendations to change diet , lifestyle modifications and
implementation non pharmacological modilities.
 Management of recurrent or chronic gout.

9. Assesment of current therapy

10. Drug Interaction
Drug-Drug Interactions
• Ketoprofen X naproxen
Effect: Both increase anticoagulation & serum potassium.
Management: By changing frequency or using alernative drugs.

11. Adverse Drug Effect:
• Hypersenstivity
• Muscle pain
• Rashes
• Fever
• Gastric irritation
• Headache
• Nausea
• Dizziness
• Liver damage
• Insomnia
• Nervousness

12. Patient Counselling:
• Keep a supply of NSAIDS and take it as soon as first symptoms appear.
• Reduce weight.
• Reduce alcohol consumption.
• Avoid daily intake of organ meat, especially liver.
• Drink plenty of water preferably 10-12 glasses per day.
• Regular follow-up at 3-month intervals.
• Report if acute attacks are frequent, not responding to NSAIDS, or if systemic features develop
• Should avoid purine-rich foods (such as beer, some fish, and spinach), and reduce their total
calorie intake and cholesterol intake.
• Pain area should be rested and use of ice may help.
• If dose is missed do not take double dose.