by clicking the arrows at the side of the page, or by using the toolbar.
by clicking anywhere on the page.
by dragging the page around when zoomed in.
by clicking anywhere on the page when zoomed in.
web sites or send emails by clicking on hyperlinks.
Email this page to a friend
Search this issue
Index - jump to page or section
Archive - view past issues
Australian Journal of Pharmacy : May 2008
education pharmacy practice research Maximising gout therapy Gout amonG men is increasinG in the West. understandinG hoW patients respond to Gout preventatives is essential in enhancinG Quality use of medicines principles and improvinG patient outcomes. focuses on identifying the significance of drug-drug interactions (both beneficial and adverse) and attempts to understand why some people did not respond well to gout prevention treatment with allopurinol. The project combines the use of clinical studies in patients and healthy subjects, along with sophisticated laboratory investigations. t his collaborative report project investigates QUM principles in people living with gout. It aJpcpd continuinG professional development By Professor AndrewMcLachlan*, University of Sydney and Concord Hospital;Professor Richard Day, St Vincent’s Hospital, Darlinghurst, NSWand University of NSW; Associate Professor Ken Williams, St Vincent’s Clinical Trials Centre and University of NSW; Professor Garry Graham, St Vincent’s Hospital Darlinghurst; Sophie Stocker PhD candidate, University of Sydney. about gout Gout is the most common inflammatory joint disease for men in the western hemisphere, where its incidence seems to be rising. Gout is caused by an excess of urate in the body, a condition known as hyperuricaemia.1 If urate concentrations remain consistently high, sodium urate crystals may be deposited within tissues and/or joints.1 Elevated urate concentrations typically arise because of either an increase in the endogenous production of urate, or by decreased elimination of urate by the kidney, or a combination of these. Furthermore, increased consumption of purine rich foods can make control of hyperuricaemia (and gout) difficult. the role of allopurinol Allopurinol is a widely used and effective treatment for gout.1 Both allopurinol and its active metabolite, oxypurinol, inhibit the synthesis of urate by blocking the enzyme xanthine oxidase.1 The effect of allopurinol is largely, if not completely, due to oxypurinol because the half-life of oxypurinol (23.4 ± 7.3 hours) is much longer than allopurinol (1.1 ± 0.3 hours).1 Allopurinol therapy is considered effective if a person with gout has no more than one acute attack of gout per year and/or if the plasma urate concentrations (a surrogate marker) are less than 0.36m, which is the limit of solubility of urate, especially if a person has frequent attacks and/or tophi.1 But many factors influence the effectiveness of the australian journal of pharmacy vol.89 may 2008 86