Gout Flashcards Preview

Pharmacology > Gout > Flashcards

Flashcards in Gout Deck (28):
1

Normal serum values of uric acid

2-7 mg/dL but this is not diagnostic

2

Gout-contributing factors

heredity, gender, age, diet, alcohol, low fluid intake, cancer, radiation therapy

3

Drug induced gout

diuretics, nicotinic acid, salicylates, EtOH, glucocorticoids, levodopa, chemotherapy, sulfa antibiotics

4

4 stages of gout

asymptomatic hyperuricemia, acute gouty arthritis, interval gout, chronic taophaceous gout

5

2 types of gout

over-producers or under excretors

6

Non-pharmacological approach to gout treatment

drink lots of water, avoid EtOH, weight loss, dietary changes

7

Drugs for gout

NSAIDs (INdometacin, ibuprofen, naproxen), calchicine (Colcrys), corticosteroids (prednisone, methylpredneisolone), probenecid (Benemid), Allopurinol (Zyloprim), Febuxostat (Uloric)

8

Treatment for acute gouty attacks

NSAIDs, Colchicine, corticosteroids

9

Colchicine (Colcrys) MOA

inhibits migration of granulocytes, which ultimately prevent uric acid deposits

10

Colchicine (Colcrys) ADRs

Diarrhea, N/V/abdpain

11

Colchicine (Colcrys) dosing

must wait 3 days before another course can be given, must adjust if CrCl

12

Contraindication of Colchicine (Colcrys)

if anuric

13

NSAIDs MOA

inhibit prostaglandin synthesis

14

NSAID most studied for gout

Indomethacin

15

Other NSAIDs for gout

naproxen or ibuprofen

16

Corticosteroids for gout

reserved for pt that fail colchicine or NSAIDs, prednisone, methylprednisolone, triamcinolone

17

Intraarticular injection of corticosteroid

Triamcinolone

18

Initiate prophylactic treatment if

severe attack of gouty arthritis, complicated course, serum uric acid level greater than 10 mg/dL, 24 hour urinary excretion greater than 1000mg, pt has 2-3 attacks/year

19

Colchicine (Colcrys) for prophylactic treatment

only give once daily, d/c if sx free for >1 year

20

Allopurinol (Zyloprim) MOA

xanthine oxidase inhibitor, preventing synthesis of uric acid

21

Allopurinol (Zyloprim)

ideal for over-producers, not for acute attack, adjust renal

22

Allopurinol (Zyloprim) ADRs

rash, can lead to Steven's Johnson syndrome

23

Febuxostat (Uloric)

Me too, $$$, once daily, no adjust, niche: more effective than allopurinol

24

Febuxostat (Uloric) MOA

xanhine oxidase inhibitor, prevent synthesis of uric acid

25

Febuxostat (Uloric) ADR

elevated liver enzymes

26

Probenecid (Benemid)

good for under excretors, do not use if CrCl

27

Probenecid (Benemid) MOA

Competitive inhibition of reabsorption of uric acid in the proximal convoluted tubule of the nephron, promoting urinary excretion of uric acid

28

Probenecid (Benemid) ADRs

GI upset (take with food), renal uric acid stones, usually well-tolerated