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Gout
USMLE Step 1
Drug | MOA & ADRs |
---|---|
Colchicine | MOA: DOC 4 acute attacks, bind tubulin disrupt macrophage migration, stop mitosis, - syn & release of leukotrienes, DOESNT prevent progression, but does suppress & help relieve pain; ADRs: dont use in pregnancy, liver & cardio disease, vomiting, ab pain |
Allopurinol | MOA: - xanthine oxidase due to it being a purine analog, used for chronic gout; ADRs: skin rashes with chronic use (hypersensitivity rxn) |
Probenecid | MOA: uricosuric agent-blocks tubular reabsorption used for chronic gout, but need high doses b/c at low doses will cause uric acid increases; ADRs: compete w/ other agents for renal transporters, i.e. penicillin = increased serum levels-useful sometimes |
Causes of gout | 1) elevated uric acid, 2) Lesch-Nyhan syndrome, 3) chemotx of malignancies, 4) renal deficiency, 5) genetic defect = increase rate of purine synthesis |
NSAIDS | acceptable for gout, but NEVER EVER USE ASPIRIN b/c it competes with uric acid at the renal transporters in the PCT |