Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cology Final thank god > NSAIDs 2 - Gout > Flashcards

NSAIDs 2 - Gout Flashcards

1
Q

What is gout?

A

Acute arhtiritis due to deposits of urate crystals in joints and cartilage
Crystals activate cytokine response
High serum uric acid levels occur due to increased production or decreased excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What acute therapy options do we have for gout?

A 
Colchicine
NSAIDs (Indomethacin, Ibuprofen, Naproxen)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is colchicine?

A

Anti-inflammatory used only in gout

Works by reducing motility leukocytes, binds tubulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Adverse effects of colchicine?

A

Nausea, vomiting, diarrhea
Cramps
All of these are signs of toxicity
D/c drug if they occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Toxicity of colchicine can lead to what?

A

Bone marrow suppression

Renal toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What NSAIDs are used for acute treatment of gout?

A

Indomethacin
Ibuprofen
Naproxen

NOT aspirin - because acetylsalicylic acid inhibits uric acid secretion

These have replaced colchicine as first line agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is first line treatment for acute gout attacks?

A

NSAIDs
Indomethacin
Ibuprofen
Naproxen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is chronic gout treated?

A 
By decreasing production of uric acid
or
Increasing excretion of uric acid
or
Increasing metabolism of uric acid to allantoin for excretion (Rasburicase! but this is for hyperuricemia caused by leukemia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is allopurinol?

A

Xanthine oxidase inhibitor

This enzyme converts purines to hypoxanthine, which is converted to xanthine and uric acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pharmacokinetics of allopurinol?

A

Rapidly absorped

Active metabolite oxypurinol has a 20 hour half life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Toxicities of allopurinol?

A

Nausea
vomiting
hepatitis
Skin rashes

25% of patients cant tolerate the side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cautions with allopurinol?

A

Avoid in kidney, liver, or heart problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is Febuxostat?

A

Non-purine, noncompetitive selective inhibitor of xanthine oxidase

(More selective than allopurinol!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is Febuxostat administered?

A

Orally absorbed (so I assume PO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Toxicities with Febuxostat?

A

Nausea, vomiting, diarrhea
Abnormal liver function tests
Hypersensitivity
Gout flair ups (lol…)

INCREASED INCIDENCE OF MI AND STROKE in trials

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Cautions with Febuxostat?

A

Avoid in cardiac, renal, hepatic disease

Counsel on shortness of breath and chest pain

2012 FDA warning on hepatic problems

17
Q

What agents decrease production of uric acid?

A

Allopurinol

Febuxostat

18
Q

Which agents increase excretion of uric acid?

A

Probenecid
Sulfinpyrazone
Rasburicase

19
Q

What is probenecid?

A

Drug combined with colchicine to increase excretion of uric acid by preventing re-absorption in the kidney

It competes with uric acid in the transporters in the proximal tubule to prevent uric acid from being re-absorbed

20
Q

How is probenecid administered?

A

Orally
MUST be taken with water to prevent urate stones in the kidney
Start low and increase dose to therapeutic effect

21
Q

Adverse effects of probenecid?

A

Skin rashes

22
Q

What is Sulfinpyrazone?

A

Analog of phenylbutazone, a strong acid that prevents uric acid re-absorption in the renal tubule

23
Q

How is Sulfinpyrazone administered?

A

Oral administration

Stay hydrated to prevent urate stones in the kidney

24
Q

Adverse effects of Sulfinpyrazone?

A

Gi irritation in 10-15% of patients
Hematological problems
Nausea, vomiting
Urate stones in kidney - stay hydrated

25
Q

What is Rasburicase?

A

Recombinant urate-oxidase (enzyme that converts uric acid into allantoin for secretion)

26
Q

Indications for Rasburicase?

A

Indicated for management of elevated uric acid levels in pediatric patients with leukemia, lymphoid, or solid tumors with increased uric acid levels due to tumor lysis by chemotherapy

27
Q

Adverse effects of Rasburicase?

A

Allergic reactions
Can develop antibodies to it
Fever
Abdominal pain

Cology Final thank god (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions