|
stone - rocks
|
05-22-2007, 08:32 AM
Which of the following medications would be most effective in preventing recurrent stone formation in a man who has just passed a uric acid stone?
A) Ethacrynic acid B) Furosemide C) Allopurinol D) Thiazide diuretics E) Potassium citrate
05-22-2007, 09:08 AM
allopurinol .
recurrent uric acid stone is one of the indication of use of allopruinol
05-22-2007, 10:28 AM
Patients with Uric acid stones are advised to stay on low protein diets to reduce acid ash (sulfur) and to reduce purines that breakdown into uric acid. Alkalinization of the urine with potassium citrate to keep the urine pH between 6.5 and 7.5 is optimal. This urine pH can be checked by the patient with the use of nitrazine paper. Diamox (Acetazolamide) may be given at night to keep urine alkaline. Sometimes Allopurinol is given if urinary uric acid remains high.
05-22-2007, 11:11 AM
Uric acid stones occur in 10% of all kidney stones and are the second most-common cause of urinary stones after calcium oxalate and calcium phosphate calculi. The most important risk factor for uric acid crystallization and stone formation is a low urine pH (below 5.5) rather than an increased urinary uric acid excretion. Main causes of low urine pH are tubular disorders (including gout), chronic diarrhea or severe dehydration. Uric acid stone disease can be prevented and these are one of the few urinary tract stones that can be dissolved successfully. The treatment of uric acid stones consists not only of hydration (urine volume above 2000 ml daily), but mainly of urine alkalinization to pH values between 6.2 and 6.8. Urinary alkalization with potassium citrate or sodium bicarbonate is a highly effective treatment, resulting in dissolution of existing stones. Urinary uric acid excretion can be reduced by a low-purine diet. Potassium citrate is the treatment of choice for the prevention of recurrence of uric acid calculi. Allopurinol reduces the frequency of stone formation in hyperuricosuric patients with recurrent uric acid stones and/or gout.
|
| « Next Oldest | Next Newest » |
