Gout drugs

Question 1

What is the pathology of gout

Answer 1

• The increased plama urate concentration is due to the overproduction of purines and/or the impaired secretion of purines
• The deposition of urate crystals leads to kinin release/generation of lukotrine LTB4 a chemotatic factor
• This leads to phagocytic neutrophil accumulation
• Free radicals are released
• This leads to cell damage and lysis

Question 2

What does the treatment aim to do

Answer 2

• Inhibit uric acid synthesis
• Increase uric acid excretion
• Inhibit inflammatory cell migration into the joints
• Give anti-inflammatory/ analgesic drugs (NSAIDs)

Question 3

Give some examples of drugs used to treat gout

Answer 3

Allopurinol 
Probenecid 
Sulphinpyrazone 
Colchicine 
NSAIDs

Question 4

What is the mechanism of action of Allopurinol

Answer 4

Reduces the synthesis of purines/uric acid

Question 5

What is the mechanism of action of Probenecid and Sulphinpyrazone

Answer 5

Increases the excreton of uric acid/ purines

Question 6

What is the mechanism of action of Colchicine

Answer 6

Inhibits leukocyte migration into the joints

Question 7

What is the mechanism of action of NSAIDs

Answer 7

Inhibit COX-1 and COx-2 so block eicosanoid synthesis and reduce pain