Summary Lecture Gout/Glaucoma

Learning Outcomes Predict the activity of a drug based on its structure & physiochemical properties Demonstrate an understanding of how the physical & chemical properties of a drug determine its pharmacology,toxicology,bioavailability and behaviour in formulations Identify typical example of drugs which are used to restore physiological functions in gout & glaucoma Describe the mechanism of therapeutic action of a selected drug at the molecular,cellular,organ system and whole body levels Describe the common adverse effects of a selected drug & their mechanism of production

Learning Outcomes Demonstrate an understanding of basic metabolism in relation to drugs & efficacy & safety in relation to the treatment of disease and/or maintenance of health Have an awareness of the risk factors & prevalence of gout & glaucoma so as to identify & refer presentations in the pharmacy appropriately

Learning Outcomes Demonstrate an understanding of the clinical & therapeutic principles of treatment of gout & glaucoma Be aware of the pharmacological & non-pharmacological aspects of managing patients with gout & glaucoma

Inflammation Be aware of the cell types involved in inflammation Be aware of the inflammatory mediators Understand the multiple roles of the prostanoids

Allergy Understand the different grades & associated symptoms of allergy Classification of allergic and anaphylactic reactions Types of hypersensitivity Role of IgE Delayed reactions

Allergy Be familiar with appropriate treatments for allergy Understand the cross-reactivity that may exist between sulfonamide antibiotics and other sulfonamide drugs Be familiar with commonly use drugs containing a sulfonamide moiety

Non-selective & selective COX-2 inhibitors Understand the role COX-1 & COX-2 play in the physiological & pathophysiological process of inflammation Be familiar with the arachidonic acid cascade

Selective COX-2 Inhibitors Understand the clinical & molecular differences between a non-selective & selective COX-2 inhibitor Understand the how binding by NSAIDs,COX-1 & COX-2 in the arachidonic acid cascade allows pharmacological targeting due to structural differences

Gout Understand the clinical features of gout Be familiar with serum urate concentrations for hyperuricaemia in males & females Understand the difference between uric acid & urate

Gout Understand the causes of hyperuricaemia Be aware of the risk factors of gout Knowledge of which medications may be predisposing to causing gout

Treatment of gout Knowledge of medications to treat & avoid in the acute attack of gout Be aware of the revised dosing recommendations for colchicine in acute gout When to avoid or reduce the dose of NSAID’s or colchicine & possible drug interactions

Maintenance of gout Urate lowering drugs available Role of xanthine oxidase Dose limitations in renal impairment Understand the rationale behind separating the treatment of acute attacks from introducing urate lowering measures Knowledge of correctable factors to treat

Glaucoma Understand the relevance of elevated intraocular pressure in the diagnosis of glaucoma Pathological features Types of glaucoma Risk factors

Treatments available to manage glaucoma For each of the different classes of eye drops to treat elevated IOP be familiar with their mechanism,efficacy,order of treatment,precautions & contraindications & interactions Understand the need for simplified dosing regimes,individualised education to improve adherence & reduce the risk of blindness

Use of eye drops Be able to instruct the patient on the correct instillation of eye drops How to minimise microbial contamination How to minimise side effects