Colchicine
________ decreases movement of granulocytes into affected area.
Gout (hyperuricemia)
disorder characterized by high level of uric acid
Von-Gierke disease
a genetic disease, deficiency of glucose-6-phosphatase
main cause of gout
under excretion of uric acid
secondary cause
cause outside the pathway of purine synthesis
examples of secondary causes of gout
Increase nuclei acids in diet
Increased cellular breakdown
Von-Gierke disease
primary cause
defect of one or more of enzymes of purine synthesis
examples of primary causes of gout
Genetic mutation of PRPP synthetase
Lesch-Nyhan syndrome
Lesch-Nyhan syndrome
genetic defect in HGPRT (Hypoxanthine-guanine phosphoribosyltransferase)
suicide inhibition:
a type of inhibition in which a substrate analog is converted to an inhibitor not released from the enzyme active site
Insoluble sodium urate crystals precipitate into:
joints
kidneys
soft tissues
gouty arthritis
deposition of needle shaped urate crystals in joints causing severe inflammation
most commonly affected joint
big toe joint
Goals of treatment for gout:
Rapid pain relief in acute attacks
Prevention of future gout attacks and the complications, by decreasing formation of uric acid
Allopurinol
analog of hypoxanthine
competitive inhibitor to xanthine oxidase
a suicide enzyme inactivator
Probenecid
Drugs that increase uric acid excretion
effective in regulation of hyperuricemia and prevention of tophii
Acute Attack treatment
analgesics and anti-inflammatory
colchicine decreases movement of granulocytes into affected area
colchicine and non-steroidal anti-inflammatory drugs can be used prophylactically to prevent acute attacks in patients with gouts
Alkalinization of urine
increase solubility of uric acid in urine
uric acid stones
Deposition of sodium urate crystals in the kidney
ethanol
decreases excretion of uric acid