Question

Sammy has come to the clinic complaining of a severe flare-up of his gout. He tells the nurse that he does not take his medicine on a regular basis because it “kills” his stomach. He also says that he hates to take medicine but hates the gout more. He has a prescription for allopurinol (Zyloprim) and a follow-up appointment for next month.

What patient teaching does Sammy need?

Answer 1

Gout : is a disease in which defective metabolism of uric acid causes arthritis, especially in the smaller bones of the feet , deposition of chalk- stones, and episodes of acute pain.

Sammy irregular intake of the medication could be because of lack of knowledge regarding the drug, its action, side effects, how it works, food to be restricted.So, now a detailed education can be given to prevent discontinuation of the Allopurinol drug.

Health Teaching to Sammy by Nurse regarding Allopurinol.

• Allopurinol is in a class of medications called xanthine oxides inhibitors.It works by reducing the production of uric acid in the body.
• High levels of uric acid may cause gout attacks or kidney stones.Allopurinol is used to prevent them once they occur.
• Allopurinol reduces both the serum and urinary uric acid levels by inhibiting the formation of uric acid.

SIDE EFFECTS OF ALLOPURINOL:

• Skin rash
• Diarrhoea
• Nausea
• Changes in the liver function test
• Gout flare up
• Fever
• Sore throat
• Headache
• Severe blistering
• Red skin rashes

Sammy should be informed to get in touch with the Physician and Nurse if he has developed side effects, so symtomatic treatment can be given and stopping of medication should not be done.

HOW DOES IT WORK:

It should be take after food with one full glas of water.

It can take 2 to 3 months to become fully effective.It does not have any effect during a gout attack, although you should continue to take it regularly everyday even if this happens.During the first few weeks of taking allopurinol, your blood levels may rise for a short while before they fall.

FOODS TO BE AVOIDED:

The following foods to be avoided when on ALLOPURINOL

• Alcohol, especially beer and hard liquor
• Red meat and organ meet such as liver or kidneys,which are high in saturated fat.
• Seafood such as lodster, shrimp,sardines,anchovies,tuna,mackerel and haddock.
• Sugary drinks and foods high in fructose.
• Refined carbohydrates.
• Processed foods

All these above health teaching should be given to Sammy and telling him to report next month for the follow up and to report immediately if any side effects occurs.