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Flashcards in Gout Deck (32):
1

Composition of Gout Crystals

Sodium Urate

2

What is tumor lysis syndrome

Massive tumor lysis
Release of nucleotides
Hyperuricemia
Renal injury

3

What is the DOC for gout pain

Indomethacin

4

What can be given to control pain in gout

Indomethacin
NSAIDs
Colchicine
Glucocorticoids

5

What can be given to treat gout (reduce serum urate)

Allopurinol
Probenecid
Sulfinpyrazone
Rasburicase

6

What suppresses leukocyte recruitment and activation

Indomethacin
NSAIDs
Colchicine
Glucocorticoids

7

Why are COX-2 inhibitor use limited

Increased CV risk

8

What are the AE for Indomethacin

Bleeding
Na, H2O retention
Renal Insufficiency

9

What do you never give for gout pain

Low dose Aspirin
Competes with urate for PT secretion

10

How does Colchicine work

Bind tubulin to inhibit MT production
Disrupts mitotic spindle
Inhibition of synth/release of LTs

11

Do we give Colchicine anymore

No...Then why the fuck are we learning this

12

Main Colchicine AE

Diarrhea

13

Other Colchicine AE

Pain
N/V
Myopathy, neutropenia, aplastic anemia, alopecia

14

When should Colchicine be given with caution

Hepatic, Renal, CV disease

15

What decreases uric acid synthesis

Allopurinol

16

How does Allopurinol work

Inhibits xanthine oxidase
Dissolutes tophi

17

What is Allopurinol an analog of

Purine

18

What is the initial effect of Allopurinol

Increase attacks
Mobilization of tissue stores of urate

19

What do you co-administer Allopurinol with

NSAID
Colchicine

20

What are the main AE of Allopurinol

HS
Skin rash --> S-J syndrome

21

Allopurinol with rash next step

Stop the damn Allopurinol

22

What prevents renal damage during cancer therapy

Allopurinol
Rasburicase

23

Reduces doses of 6-MP and Azathioprine

Allopurinol

24

How does Allopurinol decrease doses of 6-MP and Azathioprine

Xanthine oxidase metabolizes them normally

25

What enhances urate excretion

Probenecid
Sulfinpyrazone

26

How do Uricosuric agents work

Compete with urate for transporter blocking reabsorption

27

What do you coadminister uricosuric agents with

NSAIDs

28

Main AE of Sulfinpyrazone

Decrease hematopoesis
Inhibit Warfarin metabolism

29

What are the Uricosuric agent AEs

GI irritation
HS
Renal stones

30

When are Uricosuric agents contraindicated

Gout pt with nephrolithiasis/urate overproduction
Blood dyscrasia

31

How does Rasburicase work

Oxidizes uric acid to allantoin
Easily excreted

32

What is a recombinant Aspergillus uricase

Rasburicase