Osteoarthritis is a chronic degenerative disorder of synovial joints in which there is progressive softening and erosion/disintegration of the articular cartilage. In the presentation, I will deal in detail about the condition in every dimension with the most recent evidence.
Osteoarthritis is a chronic degenerative disorder of synovial joints in which there is progressive softening and erosion/disintegration of the articular cartilage. In the presentation, I will deal in detail about the condition in every dimension with the most recent evidence.
Knee pain is a very common condition. Traditional measures only address symptoms while the underlying cause is still present. Find out why and what additional steps need to be taken.
Learn more at www.HyProCure.com.
http://curegoutpainnow.com - Acute gouty arthritis is a painful condition, often affecting the toes, but it can affect many other joints as well. If left alone it can get worse, turn into a chronic problem and even cause permanent damage
Knee pain is a very common condition. Traditional measures only address symptoms while the underlying cause is still present. Find out why and what additional steps need to be taken.
Learn more at www.HyProCure.com.
http://curegoutpainnow.com - Acute gouty arthritis is a painful condition, often affecting the toes, but it can affect many other joints as well. If left alone it can get worse, turn into a chronic problem and even cause permanent damage
Addressing Osteoarthritis with Naturopathy and Holistic approaches. Also includes a reveiw of conventional treatment options. Presentation by Adam Rinde, ND, a Naturopath based in Kirkland, Washington.
Ligament Injuries - Types, Symptoms and TreatmentHealth Quest
Ligament injuries occur when a ligament is stretched beyond its normal range. Ligaments are tough band of fibrous tissues that connects bone to bone or bone to cartilage and support, stabilize and strengthen joints. The primary function of ligaments is to keep the bones in proper alignment and prevent abnormal joint movements. Leading pain management centers in Brooklyn, NYC offer effective treatment options for ligament injuries to help patients attain better mobility, balance, and strength.
According to experts, soft tissue injuries of the knee are the most common disorders presenting to the emergency department. Each year, more than 1 million emergency department visits and almost 2 million primary care visits occur due to acute knee pain.
Global Medical Cures™ | What are Knee Problems ?
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
2. Overview
2
Part 1: Degenerative & Metabolic bone disorders:
OA
Gout and gouty arthritis
Osteoporosis
Paget’s dse
Osteomalacia
Part 2: Bone infections
Part 3: Muscular disorders
Part 4: Disorders of the hand
Part 5: Spinal column deformities
Part 6 : Disorders of foot
Part 7: Sports Injuries
Maria Carmela L. Domocmat, RN, MSN 3/5/2012
3.
4. Osteoarthritis
associated with the
aging process and can
affect any joint.
The cartilage of the
affected joint is
gradually worn down,
eventually causing
bone to rub against
bone.
Bony spurs develop on
the unprotected bones,
causing pain and
inflammation. Maria Carmela L. Domocmat, RN, MSN
7. Osteoarthritis is a deterioration of cartilage and
overgrowth of bone often due to "wear and tear."
Rheumatoid arthritis is the inflammation of a joint's
connective tissues, such as the synovial membranes,
which leads to the destruction of the joint's
cartilage.
Maria Carmela L. Domocmat, RN, MSN
8. Osteoarthritis
Known as the “wear-and-tear” kind of arthritis
a chronic condition characterized by the breakdown
of the joint’s cartilage.
Cartilage is the part of the joint that cushions the ends
of the bones and allows easy movement of joints. The
breakdown of cartilage causes the bones to rub
against each other, causing stiffness, pain and loss of
movement in the joint.
Maria Carmela L. Domocmat, RN, MSN
10. Stages of osteoarthritis
Cartilage loses elasticity and is more easily damaged
by injury or use.
Wear of cartilage causes changes to underlying bone.
The bone thickens and cysts may occur under the
cartilage. Bony growths, called spurs or osteophytes,
develop near the end of the bone at the affected
joint.
Maria Carmela L. Domocmat, RN, MSN
11. Stages of osteoarthritis
Bits of bone or cartilage float loosely in the joint
space.
The joint lining, or the synovium, becomes inflamed
due to cartilage breakdown causing cytokines
(inflammation proteins) and enzymes that damage
cartilage further.
Maria Carmela L. Domocmat, RN, MSN
12. The main problem in
knee OA is
degeneration of
the articular cartilage.
Articular cartilage is the
smooth lining that covers
the ends of bones where
they meet to form the
joint. The cartilage gives
the knee joint freedom
of movement by
decreasing friction.
Maria Carmela L. Domocmat, RN, MSN
13. The articular cartilage
is kept slippery by
joint fluid made by the
joint lining (the synovial
membrane). The fluid,
called synovial fluid, is
contained in a soft
tissue enclosure around
synovial joints called
the joint capsule.
Maria Carmela L. Domocmat, RN, MSN
14. An important substance
present in articular
cartilage and synovial
fluid is called hyaluronic
acid. Hyaluronic acid
helps joints collect and
hold water, improving
lubrication and reducing
friction. It also acts by
allowing cells to move
and work within the
joint.
Maria Carmela L. Domocmat, RN, MSN
15. When the articular
cartilage degenerates,
or wears away, the
bone underneath is
uncovered and rubs
against bone.
Small outgrowths
called bone spurs,
or osteophytes, may
form in the joint.
Maria Carmela L. Domocmat, RN, MSN
16. Changes in the cartilage and bones of the joint can
lead to pain, stiffness and use limitations.
Deterioration of cartilage can:
Affect the shape and makeup of the joint so it doesn’t
function smoothly. - limp when walk or have trouble going
up and down stairs.
Cause fragments of bone and cartilage to float in joint fluid
causing irritation and pain.
Cause bony spurs, called osteophytes, to develop near the ends
of bones
Mean the joint fluid doesn’t have enough hyaluronan, which
affects the joint’s ability to absorb shock.
Maria Carmela L. Domocmat, RN, MSN
18. Causes and Risk factors
There is no single known cause of osteoarthritis
several risk factors
Age
Obesity
Injury or Overuse
Genetics or Heredity
Muscle Weakness
Other Diseases and Types of Arthritis
Maria Carmela L. Domocmat, RN, MSN
23. Management
Weight reduction
Use of splinting devices to support joints
Occupational and physical therapy
Pharmacologic management
Maria Carmela L. Domocmat, RN, MSN
27. Physical Therapy
There is no treatment to
stop the erosion of
cartilage in the joints, but
there are ways to improve
joint function. One of these
is physical therapy to
increase flexibility and
strengthen the muscles
around the affected joints.
The therapist may also
apply hot or cold
therapies such as
compresses to relieve
pain.
Maria Carmela L. Domocmat, RN, MSN
28. Supportive Devices
Supportive devices, such
as finger splints or knee
braces, can reduce stress
on the joints and ease
pain. If walking is difficult,
canes, crutches, or walkers
may be helpful. People
with osteoarthritis of the
spine may benefit from
switching to a firmer
mattress and wearing a
back brace or neck collar.
Maria Carmela L. Domocmat, RN, MSN
30. Osteoarthritis and Weight
If you're overweight, one
of the most effective ways
to relieve pain in the knee
or hip joints is to shed a
few pounds.
Even modest weight loss
has been shown to reduce
symptoms of osteoarthritis
by easing the strain on
weight-bearing joints.
Losing weight not only cuts
down on pain, but may
also reduce long-term joint
damage.
Maria Carmela L. Domocmat, RN, MSN
31. Osteoarthritis and Exercise
People with osteoarthritis may
avoid exercise out of concern
that it will cause pain.
But low-impact activities
such as swimming, walking,
or bicycling can improve
mobility and increase
strength.
Training with light weights can
help by strengthening the
muscles that surround your
joints. For example,
strengthening the quadriceps
can reduce pain in the knees.
Maria Carmela L. Domocmat, RN, MSN
33. Treatment
Acetaminophen (Tylenol)
Topical analgesics OTC
Topical salicylates (Aspercreme)
Capsaicin
Nonsteroidal anti-inflammatory drugs (NSAIDs) or COX-2
medications
Tramadol
Narcotic pain relievers
Intra-articular steroids to decrease inflammation
Hyaluronans: Hyaluronate (Hyalgan) ad hylan GF 20 (Synvisc)
Cyclobenzapine HCl (Flexeril)
glucosamine and chondroitin sulfate
Maria Carmela L. Domocmat, RN, MSN
34. Acetaminophen
Tylenol, Anacin-3, Panadal, Phenaphen, Valadol,
and others)
for mild to moderate osteoarthritis.
usually the first choice
Maria Carmela L. Domocmat, RN, MSN
36. Drugs for Prevention NSAID-Induced
Ulcers
If NSAID-induced ulcers are identified switch to
alternative pain relievers.
Maria Carmela L. Domocmat, RN, MSN
37. Topical NSAIDs
$63.07
Maria Carmela L. Domocmat, RN, MSN
38. Capsaicin (Zostrix)
is an ointment prepared from the active ingredient
in hot chili peppers that has been helpful for
relieving painful areas in other disorders.
Maria Carmela L. Domocmat, RN, MSN
40. Tramadol (Ultram)
is a pain reliever that has some properties that are
similar to narcotics.
not as addictive, however, and may be an
alternative for patients who do not respond to
NSAIDs or less potent agents.
Maria Carmela L. Domocmat, RN, MSN
42. Narcotic pain relievers
oxycodone, oxymorphone, or morphine
may be necessary for severe pain that does not
respond to less potent pain relievers.
Maria Carmela L. Domocmat, RN, MSN
43. Maria Carmela L. Domocmat, RN, MSN
http://differncebetween.infoloommedia.netdna-cdn.com/wp-
content/uploads/2009/11/oxycodone.png
44. Supplements
Overall studies suggest no
benefits of glucosamine
and chondroitin –
supplements available at
pharmacies and health
food stores touted for
relieving pain and
stiffness for people with
osteoarthritis.
Check with doctor before
using chondroitin,
especially if taking blood-
thinners.
Maria Carmela L. Domocmat, RN, MSN
45. Intra-articular steroids
Generic Name Brand Name
betamethasone Celestone
methylprednisolone Depo-Medrol
triamcinolone Kenalog
Maria Carmela L. Domocmat, RN, MSN
48. Preventing Osteoarthritis
The most important thing you can
do to ward off osteoarthritis is
keep your weight in check.
Over the years, extra weight puts
stress on the joints and may even
alter the normal joint structure.
Preventing injuries is also
important.
Take precautions to avoid
repetitive motion injuries on the
job.
If you play a sport, use proper
equipment and observe safety
guidelines.
Maria Carmela L. Domocmat, RN, MSN
50. Gouty arthritis
is a disease characterized by an abnormal
metabolism of uric acid, resulting in an excess of
uric acid in the tissues and blood causing
inflammation
People with gout either produce too much uric acid,
or more commonly, their bodies have a problem in
removing it.
Maria Carmela L. Domocmat, RN, MSN
51. Gouty arthritis
AKA
Gout
The disease of kings
The king of diseases
Maria Carmela L. Domocmat, RN, MSN
52. Gouty arthritis
2 major types
Primary
Secondary
Maria Carmela L. Domocmat, RN, MSN
53. Primary Gouty arthritis
Inherited X-lined trait
Caused by several inborn errors of purine
metabolism
Uric acid- is the end-product of purine metabolism;
excreted in urine
Production of uric acid exceeds the excretion
capability of kidneys
Sodium urate is deposited in the synovium and other
tissues which results in inflammation
Males, 30’s and 40’s
Maria Carmela L. Domocmat, RN, MSN
54. Secondary Gouty arthritis
Affects all ages
Hyperuricemia : Excessive uric acid in blood caused by
another disease
Renal insufficiency
Diuretic therapy
Multiple myeloma
Carcinomas
Causes:
decreased normal excretion of uric acid and other waste
products
Increased production of uric acid
Maria Carmela L. Domocmat, RN, MSN
55. Four Stages Of Gouty Arthritis
Asymptomatic Hyperuricemia
Acute Gout / Acute Gouty Arthritis
Interval / Intercritical
Chronic Tophaceous Gout
Maria Carmela L. Domocmat, RN, MSN
56. Four Stages Of Gouty Arthritis
(1) Asymptomatic Hyperuricemia:
Asypmptomatic but with elevated blood uric acid
levels
Serum uric acid level (mg/dl) Incidence of gout
>9.0 7.0-8.9
7.0-8.9 0.5-0.37
<7.0 0.1%
Maria Carmela L. Domocmat, RN, MSN
57. Four Stages Of Gouty Arthritis
(2) Acute Gout / Acute Gouty Arthritis
First “attack” of GA
hyperuricemia has caused deposits of uric acid crystals
in joint spaces, leading to gouty attacks.
Excruciating pain and inflammation of one or more
joints – esp metatarsophalangeal joints of the great toe
(podagra)
Increased ESR, WBC
Maria Carmela L. Domocmat, RN, MSN
58. Note: Excessive alcohol and fad “starvation” diets can
cause acute gouty attacks
Maria Carmela L. Domocmat, RN, MSN
62. Four Stages Of Gouty Arthritis
(3) Interval / Intercritical
the periods between acute gouty attacks – may be
months or years after the 1st attack
Asymptomatic period
No abnormality in joints
(4) Chronic Tophaceous Gout:
the disease has caused permanent damage
Deposits or urate crytals under skin and within major
organs (i.e., urate kidney stone formation)
Maria Carmela L. Domocmat, RN, MSN
63. Tophi
Tophi – deposits of sodium urate crystals
May occur anywhere; common in outer ear
http://www.hopkins-arthritis.org/images/gout_fig7.gif
Maria Carmela L. Domocmat, RN, MSN
72. Management
Drug therapy
acute gouty arthritis – inflammation subsides
spontaneously within 3 to 5 days
But if cannot tolerate pain
Colchicine (Colsalide, Novocolchicine) and NSAIDs
Taken for 4-7 days
(NSAIDs) -Indomethacin (Indocin), ibuprofen (Advil), and
naproxen (Aleve), celecoxib (Celebrex)
painkillers such as codeine, hydrocodone,
and oxycodone
Corticosteroids
Maria Carmela L. Domocmat, RN, MSN
73. Management
Drug therapy: Chronic or repeated acute episodes
Uricosuric drug
1. Allopurinol (Zyloprim)
2. Probenecid (Benemid, Benuryl)
Combination drug
Probenecid and Colchicine (ColBenemid)
Maria Carmela L. Domocmat, RN, MSN
74. Management
Drug therapy: Chronic or repeated acute episodes
Uricosuric drug – promotes excretion of excess uric acid
Promote uric acid excretion or reduce its production
1. Allopurinol (Zyloprim)
A xanthine oxidase inhibitor – prevents conversion of
xanthine to uric acid
2. Probenecid (Benemid, Benuryl)
drink at least 2 liters of fluid a day while taking this
medication (to help prevent uric acid kidney stones from
forming).
Maria Carmela L. Domocmat, RN, MSN
75. Management
Drug therapy: Chronic or repeated acute episodes
Combination drug
Probenecid and Colchicine (ColBenemid)
Note: avoid aspirin – it inactivates the drug
Monitor serum uric acid level
Maria Carmela L. Domocmat, RN, MSN
77. Febuxostat (Uloric)
first new medication developed specifically for the
control of gout in over 40 years.
Decreases formation of uric acid by the body and is a
very reliable way to lower the blood uric acid level.
can be used in patients with mild to moderate kidney
impairment.
should not be taken with 6-mercaptopurine (6-MP), or
azathioprine.
http://www.emedicinehealth.com/gout/page7_em.htm#Medications
Maria Carmela L. Domocmat, RN, MSN
82. Management: Diet therapy
Avoid legumes (dried beans
alcohol and peas)
anchovies Gravies
sardines mushrooms
oils spinach
organ meat (liver, asparagus
kidney, and cauliflower
sweetbreads) baking or brewer's
yeast
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001459/
Maria Carmela L. Domocmat, RN, MSN
83. Management: Diet therapy
Limit meat
Avoid fatty foods such as salad dressings, ice
cream, and fried foods.
Eat enough carbohydrates.
If losing weight, lose it slowly. Quick weight loss
may cause uric acid kidney stones to form.
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001459/
Maria Carmela L. Domocmat, RN, MSN
85. Management: Diet therapy
Avoid all forms of aspirin and diuretics – may
precipitate attack
Excessive physical or emotional stress- can
exacerbate disease
Maria Carmela L. Domocmat, RN, MSN
86. Prevention of kidney stone formation
Increase fluid intake
To prevent stone formation
Dilute urine and prevent sediment formation
Alkaline ash diet
Citrus fruits, juices, milk and certain dairy products
Uric acid is more soluble in high pH urine – less likely
to form urinary stones
Maria Carmela L. Domocmat, RN, MSN
87. Complications
Chronic gouty arthritis
Kidney stones
Deposits in the kidneys, leading to chronic kidney
failure
Maria Carmela L. Domocmat, RN, MSN