| Drug and Dosage | Use | Action | Assessment: Side Effects |
|---|
| Allopurinol (Lopurin, Zyloprim)—PO 100 mg initially, 300 mg daily with meals or pc | Primary hyperuricemia, secondary hyperuricemia with cancer therapy | Lowers plasma and urinary uric acid levels; no analgesic, anti-inflammatory, or uricosuric actions | Rash, itching; nausea, vomiting; anemia, drowsiness |
| NURSING IMPLICATIONS: Report side effects, particularly rash , because drug must be stopped; avoid driving or other complex tasks until drug effects known; give at least 3,000 mL fluid daily; minimum urine output of 2,000 mL/day; keep urine neutral or alkaline with sodium bicarbonate or potassium citrate; use cautiously with: liver disease, impaired renal function, history of peptic ulcers, lower GI disease, or bone marrow depression |
| Colchicine—PO 1.0–1.2 mg acute phase; 0.5–2.0 mg nightly with milk or food; IV 1–2 mg initially | Gouty arthritis, acute gout | Inhibits leukocyte migration and phagocytosis in gouty joints; nonanalgesic, nonuricosuric | Nausea, vomiting, diarrhea, abdominal pain; peripheral neuritis; bone marrow depression (sore throat, bleeding gums, sore mouth); tissue and nerve necrosis with IV use |
| NURSING IMPLICATIONS: Do not dilute IV form with normal saline or 5% dextrose—use sterile water to prevent precipitation; infuse over 3–5 min IV; potentiate drug action with alkali-ash foods (milk, most fruits and vegetables) |
| Probenecid (Benemid)—PO 0.25–0.50 gm twice daily pc | Chronic gouty arthritis (no value in acute); adjuvant therapy with penicillin to increase plasma levels | Inhibits renal tubular resorption of uric acid; no analgesic or anti-inflammatory activity; competitively inhibits renal tubular secretion of penicillin and many weak organic acids | Headache; nausea, vomiting, anorexia, sore gums; urinary frequency, flushing |
| NURSING IMPLICATIONS: Give with food, milk, or prescribed antacid; 3,000 mL/day fluids; avoid alcohol, which increases serum urates; do not take with aspirin—inhibits action of drug; renal function and hematology should be evaluated frequently; during acut gout, give with colchicine |