Chapter 48: Gout Flashcards Preview

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Flashcards in Chapter 48: Gout Deck (16)
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1

Colchicine MOA

Inhibits microtubule formation by binding to tubulin

Interrupts cell motility and other things needed for inflamm process

Limits inflamm by blocking neutrophil activation

2

What type of joint disease are glucocorticoids steroids) used for?

acute polyarticular gout - can be injected directly into the joint

3

What NSAID is used most frequently to treat the pain associated with Gout?

indomethacin (ibuprofen runner up)

4

Allopurinol MOA

Inhibits xanthine oxidase

Decreases breakdown of GMP and AMP into uric acid....this way uric acid does not build up in the blood

5

Oxypurinol MOA

basically "freezes" xanthine oxidase

6

Inhibiting xanthine oxidase leads to a build up of what in the blood? Is this an issue?

Buildup of xanthine and hypoxanthine

not an issue because these are pretty soluble in the blood! they can be filtered by the kidney without crystal deposition

7

What would you administer in the case of acute gouty attack?

Colchicine or NSAID

NOT ALLOPURINOL!!!! this could potentially worsen gout at this time

8

During the first 4-6 months of allopurinol therapy, what should you administer along with it?

Colchicine or NSAID to reduce risk of precipitating an attack

9

What skin issue is a potential adverse effect of allopurinol?

A rash that can progress to the nastyass Stevens Johnson syndrome

= if you get rash, DISCONTINUE!

10

Febuxostat MOA

nonpurine inhibitor of xanthine oxidase - recently approved

Chronic gout tx

11

Febuxostat is metabolized where?

In the liver. So if pt has renal issue, you may not have to adjust dose.

12

Which 2 drugs inhibit URAT1, leading to increased excretion of uric acid? Which is more potent?

Probenecid
Sulfinpyrazone (more potent)

13

Losartan

MOA: angiotensin II receptor antagonist
TX: pts with hypertension&gout

14

What is tumor lysis syndrome and what medications can be used to treat it?

Chemo --> rapid lysis of tumors --> liberate nucleotides and increase plasma urate --> massive renal injury

Rasburicase!
Allopurinol actually can help too

Raspberries have little nubs that look like tumors all over it

15

Urate is LESS soluble at lower or higher temepratures?

lower

16

Why would patients not adhere to colchicine therapy? (i.e. what is a common adverse effect?)

diarrhea