Gout Drugs

Question 0

Cortisone

Answer 0

Corticosteroid for jt inflammation. Injected for gout.
MOA - inhibits inflammatory protein synthesis.
SFx: Systemic - Hyperglycemia, insulin resistance, DM, osteoporosis, anxiety, depression, amenorrhea, cataracts and gaucoma. At site of injection - pn, infx, pigment changes, loss of fat, tendon weakness.

Question 1

Indomethacin (Indocin)

Answer 1

NSAID for gout, arthritis, bursitis, migraine, HA, hemicrania, pn and swelling.
MOA - reversible COX1 and COX2 inhibition. PO, PR, IM.
SFx - Bleeding, gastritis, PUD, may exacerbate HTN and/or CHF in pts with preexisting LV or KI dz. Avoid using in pts with hx of aspirin allergy, hayfever asthma and nasal polyps.

Question 2

Colchicine

Answer 2

Mitotic inhibitor. Used for gout both prophylactically and acutely.
MOA - Inhibits microtubule polymerization by binding tubulin, inhibiting mitosis in affected cells. This action is more pronounced in neutrophils. PO.
SFx: GI upset, anemia, neutropenia, hair loss, PERIPHERAL NEUROPATHY. OD sxs include: N/V, diarrhea, renal failure, hypovolemic shock. No antidote is known. NARROW TI. Do not use during pg or breastfeeding.

Question 3

Allopurinol (Zyloprim)

Answer 3

Purine analog, used for gout, hyperuricemia, and as prophylaxis against tumor lysis syndrome.
MOA - Xanthine oxidase inhibitor. PO.
SFx: N/V, skin rash, SJS

Question 4

Probenecid (Probalan)

Answer 4

Uricosuric, used for hyperuricemia, gout.
MOA - increased permeability of renal tubule to uric acid. PO.
SFx: N/V, gi upset, increased instance of uric acid stones (use cautiously in pts with hx of kidney stones).