Flashcards in Chapter 48: Gout Deck (16)
Inhibits microtubule formation by binding to tubulin
Interrupts cell motility and other things needed for inflamm process
Limits inflamm by blocking neutrophil activation
What type of joint disease are glucocorticoids steroids) used for?
acute polyarticular gout - can be injected directly into the joint
What NSAID is used most frequently to treat the pain associated with Gout?
indomethacin (ibuprofen runner up)
Inhibits xanthine oxidase
Decreases breakdown of GMP and AMP into uric acid....this way uric acid does not build up in the blood
basically "freezes" xanthine oxidase
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
What would you administer in the case of acute gouty attack?
Colchicine or NSAID
NOT ALLOPURINOL!!!! this could potentially worsen gout at this time
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
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!
nonpurine inhibitor of xanthine oxidase - recently approved
Chronic gout tx
Febuxostat is metabolized where?
In the liver. So if pt has renal issue, you may not have to adjust dose.
Which 2 drugs inhibit URAT1, leading to increased excretion of uric acid? Which is more potent?
Sulfinpyrazone (more potent)
MOA: angiotensin II receptor antagonist
TX: pts with hypertension&gout
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
Allopurinol actually can help too
Raspberries have little nubs that look like tumors all over it
Urate is LESS soluble at lower or higher temepratures?