Drugs For Gout

Question 1

Inhibits uric acid synthesis by inhibiting xanthine oxidase
Decrease overall urate burden
More soluble hypoxanthine and xanthine

Preferred standard care in between acute attacks
Also antiprotozoal
Prevents massive uricosuria after therapy for blood dyscrasia

Answer 1

Allopurinol

Question 2

First non purine inhibitor of xanthine oxidase

Reduce formation of xanthine and uric acide without affecting other enzymes in pathway

Answer 2

Febuxostat

Question 3

Decreases net reabsorption of uric acid in PCT

PK
Probenecid completely reabsorbed by renal tubules
Sulfinpyrazolne rapidly excreted by kidneys

Indications: when allopurinol or febuxostat is contraindicated; for tophaceous gout

Adverse: GI irritation

Answer 3

Probenecid and Sulfinpyrazone(uricosuric)

Question 4

Primary treatment for acute gout

Inhibits formation of LTB4(Leukotriene B4)

Answer 4

Colchicine

Question 5

Inhibits PG synthesis
Inhibits urate crystal phagocytosis

Indomethacin

Answer 5

NSAIDS

Question 6

For severe, symptomatic gout
Oral prednisone
Intraarticular triamcinolone

Answer 6

Glucocorticoid

Question 7

Converts uric acid to allantoin which is highly soluble and excreted in urine

Adverse: hemolytic anemia in G6PD deficient

Answer 7

Pegloticase