58. Gout drugs Flashcards Preview

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Flashcards in 58. Gout drugs Deck (31)
1

gout drugs are divided to

1. chronic gout drugs ( preventive )
2, Acute gout drugs

2

Acute gout drugs ?

1. nSAID
2. Glucocorticoids
3. Colchicine

3

acute gout drugs - which NSAIDS

naproxen
indomethacin

4

acute gout drugs - glucocorticoids - way of administration

oral or intracular

5

colchicine - mechanism of action

binds and stabilizes tubulin to inhibit microtubule polymerization, impairing neutrophil chemotaxis and degranulation

6

colchicine - binds and stabilized tubuli to inhibit microtubule polymerization, impairing,...

impairing neutrophil chemotaxis and degranulation

7

side eddects of colchicine

GI upset

8

colchicine action on gout

acute and prophulactic value

9

salicilates - gout

do not salicylates --> all but the highest doses depress uric acid clearance . Even high doseses ( 5-6g/day) have only minor uricosuric activity

10

chronic gout drugs

1. allopurinol
2. febuxostat
3. pegloticase
4. probencid

11

purine to urine ( pathway and enzymes )

purine --> hypoxanthine --> xanthine ( xanthine oxidase) --> plasma uric acid ( xanthine oxidase ) ---> URINE

12

febuxostat - mechanism of action

inhibits xanthine oxidase

13

allopurinol - active form

alloxanthine

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allopurinol - mechanism of action

competitive inhibitor of xanthine oxidase after being coverted to alloxanthine

15

allopurinol - clinical use

1. chronic gout ( prophylactis)
2. lymphoma
3. leukemia

16

allopurinol - clinical use - lymphoma and leukemia ?

prevent tumor lysis - associated urate nephropathy

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drugs that normally metabolised by xanthine oxidase

azathioprine
6-MP

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probenecid - mechanism of action

inhibits reasborption or uric acid in proximal convulated tubulle ( also inhibits secretion of penicillin

19

probenecid - inhibits reabsorption or uric acid in

proximal convoluted tubule

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probenecid - inhibits secretion of

penicillin

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probenecid - side effect

it can precipitate uric acid calculi

22

pegloticase - mechanism of action

recombinant uricase that catalyze metabolism or uric acid to allantoin ( a more wate - soluble product)

23

pegloticase - recombinant uricase that catalyze metabolism or uric acid to

allantoin

24

xanthine oxidase inhibitors

1. allopurinol
2. febuxostat

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uric acid - tubular reabsorption - inhibitors

1. probenecid
2. high doses of salicilates

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uric acid - tubular secretion - inhibitors

1. diuretics
2. low dose salicilates

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uric acid vs allantoin

allantoin is more water soluble product

28

gout - drug that also inhibits the secretion of penicillin

probenecid

29

recombinant uricase - deug

1. pegloticase
2. rasburicase

30

uricosuric activity ?

increase the excretion of uric acid in the urine

31

purine to urine ( pathway and enzymes )

purine --> hypoxanthine --> xanthine ( xanthine ( xanthine oxidase) --> plasma uric acid ( xanthine oxidase --> URINE

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