Gout Treatment - Xanthine Oxidase Inhibitors - Allopurinol and Febuxostat - Pharmacology

hey it's medicos is perfection elsewhere medicine makes perfect sense and today we'll talk about a xanthine oxidase inhibitors known as Ella Piron all that being said now let's get started we have talked about the management of gout in the previous video so please watch these videos in order this is my Rheumatology playlist so I've been telling you about pick monic before now officially we have partnered together yes indeed it's happening and they have given me permission to share something epic with you so please stick around so here's the purine synthesis and this is the purine

degradation hi presenting and to xanthine and to uric acid was the enzyme here xanthine oxidase how do we inhibited allopurinol or free boxer Stan treatment of gout how do you do it there's the acute gout and the chronic gout acute gout nonsteroidals steroidal or called colchicine how does colchicine work it inhibits neutrophil chemotaxis chronic gout decreased production or increased excretion using LPL or free boxes tat because they are xanthine oxidase inhibitor probenecid will inhibit the reabsorption of uric acid the raspberries and piggledy cage will destroy the uric acid if you remember my hematology playlist we

have talked about myeloproliferative and lymphoproliferative ordered before myeloproliferative in all of them you have increased level of RBC's granulocytes and thrombocytes the myeloproliferative neoplasms are many including CML and you have polycythemia vera and essential thrombocytosis in all of them you have increased RBC's white blood cells and places but in CML it's mostly basophils and positive Avira it's mostly RBC's initiative is to mostly platelets myeloproliferative neoplasm we have polycythemia vera there is predominantly increased number of RBC's issues on potatoes lay the CML basophils so how is that related to El appear in oh look at this

all of them have a rapid cell turnover because there is proliferation nucleus breakdown and turnover leading to purine metabolism uric acid and can precipitate the gout attacks of course before we can make uric acid we need xanthine oxidase so the entity an oxidase is responsible for the formation of uric acid what if we can inhibit the this then same oxidase using allopurinol or Phivolcs usted we can prevent the formation of uric acid bingo we have talked about all of them and the genetic problems and all of this in my hematology playlist and here is case

number two for eeeh the previous case is in my Rheumatology playlist please read it pause and let me know the answer in the comment section so now I understand why do we use allopurinol in gout and I understand why do we use it in myeloproliferative neoplasms how about tumor lysis syndrome you have a tumor and then your doctor is giving you chemotherapy tumor has what rapid proliferation proliferation and this rapid destruction of the tumor destruction destruction tumors have cells cells have nucleus and nucleus has DNA DNA has purines purine degradation will yield uric acid how

did PN metabolism yield uric acid xanthine oxidase baby what if we can inhibit it using LP know you will prevent the formation of uric acid allopurinol what's the mechanism xanthine oxidase inhibitor uses chronic gout hyperuricemia tumor lysis syndrome myeloproliferative neoplasm side effects nausea vomiting diarrhea rash hypersensitivity reactions and they were discussed in detail in the previous video drug-drug interaction do not give it with either fibrin for six more caps appearing if you have to please lower the dose of azo fibrin or six mercaptan purine also if you decide to use LP anole you need to

monitor or adjust the dose if the GFR is too low fie box usted is similar to el appear now however I have good news and bad news good news there is no need to adjust the dose based on the GFR bad news it's more expensive so allopurinol and Phivolcs usted can be used in all of these conditions such as chemotherapy leukemia tumor lysis syndrome myeloproliferative neoplasms anemia is an even psoriasis and now to the best part of the lecture this is pic Manik man look at this this is gout gout here is goat gout goat

and we have two goats this goat is acute gout and this one is chronic gout acute look at this acute angle how can we treat acute gout nonsteroidals glucocorticoids and colchicine nonsteroidals NSAIDs NSAIDs look at this this is an N that is sad n seds glucocorticoids gluco here is a glue and quarter and then on steroids how about colchicine a cult of cheese what's the mechanism of action of colchicine it inhibits leukocyte chemotaxis chemo taxi and leukocyte here is luke that was acute gout how about the chronic gout the Crone goat xanthine oxidase inhibitors xanthine

oxidase xylophone Ox Daisy and inhibition these are the chains allopurinol Phivolcs usted allopurinol alloy piranha and Phivolcs usted is the fat boxer or to treat chronic gout you can give drugs that will enable the absorption of uric acid such as probenecid and this is the probe so to treat acute gout you will need nonsteroidals steroids or colchicine how does colchicine work it inhibit leukocyte chemotaxis to treat chronic gout he either use xanthine oxidase inhibitors such as allopurinol and Phoebus usted or you probe me with probenecid to inhibit the reabsorption of the unicorn I mean New

York acid but wait it gets better if you click on the review button at pic Manik now it's empty now you can recall it so let's practice recall guys why not what was here the acute goat what was here the chronic goat how do you treat acute gout we had nonsteroidals here we had the glucocorticoids and we had the cult of cheese and they work by inhibiting leukocyte chemo taxi cool how do you treat chronic gout you either give a xanthine oxidase inhibitor remember the oxidase E and this was LP renal and Phivolcs usted or

you probe me with probenecid because it will inhibit uric acid reabsorption now let's check it again and as you see here we were correct pause the video and look at this picture again and then after each pic monic they give you a quiz so that you can test your notes which medications mechanism of action is the inhibition of xanthine oxidase and the answer of course is allopurinol if LP or no not an option choose the boxer stead Expo for xanthine oxidase and stead for inhibition and even like it gets better this were the location of

allopurinol Socrates once said the unexamined life is not worth living medic OSHA says the unpick monix life is not worth living what are you waiting for go to pick Manik Calm / VIP hookup / mini kosis thank you for watching subscribe hit the bell and click on the join button you can support me here or here just click on this link to help the channel thank you so much for watching as always be safe stay happy and study hard this is medicals perfection arrows where medicine is fun and makes perfect sense go to pick Manik

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