Anti-Inflammatory: Gout Drugs

Question 1

_________ metabolism produces uric acid

Answer 1

purine

Question 2

Purines are converted into

Answer 2

hypoxanthine

Question 3

Xanthine oxidase converts

Answer 3

1. Hypoxanthine to xanthine

2. Xanthine to uric acid

Question 4

_____________ treat acute gout and pseudogout

Answer 4

1. NSAIDs (e.g. indomethacin)
2. Glucocorticoids (e.g. oral prednisone)
3. Colchicine

Question 5

Colchicine binds

Answer 5

intracellular tubulin preventing polymerization of microtubules

Question 6

Colchicine disrupts

Answer 6

the cytoskeleton of neutrophils thereby inhibiting neutrophil migration, phagocytosis, and degranulation

Question 7

Colchicine can cause

Answer 7

diarrhea

Question 8

Pseudogout is

Answer 8

positively birefringent (blue under polarized light) and forms rhomboid-shaped crystals

Question 9

_________ manages chronic gout

Answer 9

1. Allopurinol
2. Febuxostat
3. Probenecid
4. Pegloticase

Question 10

Allopurinol inhibits

Answer 10

xanthine oxidase

Question 11

_______ inhibits xanthine oxidase

Answer 11

1. Allopurinol

2. Febuxostat

Question 12

Uric acid crystals can form in

Answer 12

tumor lysis syndrome after starting cytotoxic chemotherapy

Question 13

Tumor lysis syndrome is most common with treatment of

Answer 13

lymphoma and acute lymphoblastic leukemia

Question 14

_______ prevent uric acid crystal deposition in setting of tumor lysis syndrome

Answer 14

Allopurinol

Question 15

Lesch-Nyhan syndrome (associated with hyperuricemia) is managed with

Answer 15

Allopurinol

Question 16

Allopurinol manages

Answer 16

1. Gout
2. Pseudogout
3. Tumor Lysis Syndrome
4. Lesch-Nyhan syndrome

Question 17

Allopurinol inhibits

Answer 17

breakdown of purine analogs (e.g. 6- mercaptopurine and azathioprine) increasing risk of toxicity

Question 18

Allopurinol can cause

Answer 18

1. Stevens-Johnson syndrome

2. Drug reaction with eosinophilia and systemic symptoms (DRESS syndrome)

Question 19

Probenecid is a

Answer 19

1. Uricosuric agent

2. Sulfa drug

Question 20

Probenecid decreases

Answer 20

renal tubular reabsorption of uric acid

Question 21

Probenecid can increase the risk of

Answer 21

renal stone formation due to increased uric acid excretion

Question 22

Probenecid can inhibit the excretion of

Answer 22

many drugs

Question 23

Probenecid prevents renal excretion of

Answer 23

penicillin

Question 24

Aspirin at high doses prevents

Answer 24

reabsorption of uric acid

Question 25

Aspirin at low doses inhibits

Answer 25

uric acid excretion

Question 26

Pegloticase converts uric acid into

Answer 26

water soluble allantoin

Question 27

Pegloticase is a

Answer 27

recombinant uricase used in chronic gout management

Question 28

Pegloticase can cause

Answer 28

1. Hemolysis in G6PD deficiency (bite cells)

2. Anaphylaxis

Question 29

Pegloticase is administered

Answer 29

IV