Monday, March 14, 2016

Hyperuricaemia : Akuarit 4


Availability
  • per Tab Ethambutol HCl 275 mg, rifampicin 150 mg, isoniazid 75 mg, pyrazinamide 400 mg
Most likely causative agent:
  • Pyrazinamide
Management
  • As a result of inhibition of renal tubular secretion, a degree of hyperuricaemia usu­ally occurs,  but this is often asymptomatic.
  • Arthralgia, particularly of the shoulders, may occur and is responsive to simple analgesics (especially aspirin).
  • Both hyperuricaemia and ar­thralgia may be reduced by prescribing regimens with intermittent administration of pyrazinamide.
  • Acute liver damage and hyperuricaemia have been reported in cases of overdosages
Treatment
  • Gout requiring treatment with allopuri­nol occasionally develops.
  • Asymptomatic hyperuricemia is common and treatment is generally unnecessary.
  • The diagnosis of gout requires confirmation of the presence of monosodium urate crystals in synovial fluid
  • Pyrazinamide and ethambutol-induced hyperuricemia can normally be controlled by xanthine oxidase inhibitors
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189695/
References:
  1. WHO Treatment of tuberculosis: guidelines – 4th ed / 2010 
  2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189695/
  3. http://www.medscape.com/viewarticle/562264_2

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