Gout

Question 1

Uricosuric drugs

Answer 1

Probenecid
Sulfinpyrazone
Lesinurad

Question 2

Uricosuric drugs - Clinical use

Answer 2

Prevent gout attacks in persons who under-excrete uric acid.

Question 3

Probenecid - MoA

Answer 3

Increases excretion of uric acid by competitive inhibition of uric acid reabsorption

Question 4

Probenecid - Interactions

Answer 4

Aspirin and salicylates: interfere with the uricosuric effect.
High dose of salicylates: inh uric acid reabsorption
Low doses of salicylates: inh uric acid secretion

Question 5

Sulfinpyrazone - MoA

Answer 5

Complete inhibition of urate reabsorption, increasing uric acid excretion

Question 6

Sulfinpyrazone - Adverse

Answer 6

GI, renal and hematologic adverse effects

Question 7

Lesinurad - MoA

Answer 7

Reduces uric acid levels by inh the function of transporters responsible for uric acid reabsorption, uric acid transporter 1 and organic anion transporter 4.

Question 8

Xanthine oxidase inhibitors

Answer 8

Allopurinol

Febuxostat

Question 9

Xanthine oxidase inhibitors - MoA

Answer 9

Decreases production of uric acid

Question 10

Xanthine oxidase inhibitors - Clinical use

Answer 10

Prevent gout attacks in people who overproduce uric acid.

Prevent hyperuricemia and gout in persons having cancer chemotherapy and whose rate of purine catabolism is high.

Question 11

Allopurinol - MoA

Answer 11

Competitive inhibitor of xanthine oxidase
Converted to active metabolite oxypurinol in the liver
Decrease in uric acid excretion and corresponding increase in urinary excretion of hypoxanthine.

Question 12

Allopurinol - Clincal use

Answer 12

Hyperuricemia and gout in cancer patients with high purine catabolism
Prevent the occurrence or progression or both gouty arthritis and urate nephropathy

Tumor lysis syndrome
Lesch-Nyhan syndrome

Question 13

Allopurinol - Adverse

Answer 13

Nausea, vomiting, hepatitis, skin rashes, hypersensitivity.
Steven-Johnson syndrome
Eosinophilia
DRESS syndrome

Question 14

Allopurinol - Interactions

Answer 14

Inhibits catabolism of azathioprine and mercaptopurine

Question 15

Febuxostat - MoA

Answer 15

Competitive inhibitor of xanthine oxidase

Question 16

Febuxostat - Adverse

Answer 16

Liver enzyme elevations, nausea, arthralgia, rash

Question 17

Catabolic enzyme preparations

Answer 17

Pegloticase and Rasburicase

Question 18

Catabolic enzyme preparations - MoA

Answer 18

Reverse hyperuricemia

Question 19

Pegloticase - Clinical use

Answer 19

Refractory chronic gout

Question 20

Pegloticase - Adverse

Answer 20

Life-threatening allergic reactions

Hemolysis in G6PD deficiency

Question 21

Rasburicase - Clinical use

Answer 21

ONLY: initial management of plasma uric acid in pediatric and adults with leukemia, lymphoma and solid tumor malignancies who are receiving anticancer therapy

Question 22

Rasburicase - Adverse

Answer 22

Allergic reactions

Question 23

Drugs for treating gout attacks

Answer 23

Indomethacin
Clochicine
Prednisone

Question 24

Indomethacin - MoA

Answer 24

Anti-inflammatory drug for rapid relief of pain

Question 25

Clochicine - MoA

Answer 25

Disrupting microtubules and inh of inflammatory leukocyte motility –> blocking their ability to cause urate crystal-induced joint inflammation

Question 26

Clochicine - Adverse

Answer 26

Nausea, vomiting, diarrhea, abdominal cramps

Question 27

Indomethacin, Clochicine, Prednisone - Clinical use

Answer 27

Acute gout