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Pharm 47 Gout
LECOM Pharm Ch 47 Integrated Gout
| Question | Answer |
|---|---|
| Treat Acute Gout with what 3 classes of drugs | NSAIDS; colchicine; glucocorticoids |
| Treat Chronic gout with what 3 drugs | Allopurinol; Probenecid; Sulfinpyrazone |
| MOA of colchicine | inhibits microtubule formation |
| Colchicine commonly causes this SE | Diarrhea |
| 2 more sever SE of colchicine | myelosupression, neuromyopathy |
| 3 drugs that can cause toxic blood levels of colchicine | cyclosporine, tacrolimus, verapamil |
| NSAID used commonly in gout | indomethacin |
| This can be injected into a gouty joint | methylprednisolone |
| MOA of Allopurinol | oxidized to oxypurinol and then inhibits molybdenum oxidative state conversion in xanthine oxidase; decreasing uric acid synthesis |
| Blood levels of what 2 metabolites increase with allopurinol use 2 xanthine and hypoxanthine | |
| Cancer or transplant recipients can have toxic levels of what 2 drugs when used with Allopurinol | azathioprine and mercaptopurine |
| When a Pt presents with polyarticular gout and renal insufficiency, what can be used as an antiinflamitory agent? | Glucocorticoids |
| Cochicine used an lower what product of arachadonic acid | LTB4 |
| If a Pt starts taking allopurinol and develops a skin rash, why is the drug stopped? | Possibility of developing Stephen-Johnson Syndrome |
| When first starting allopurinol treatment, what else should the Pt be given and why? | Either colchicine or an NSAID to prevent initial precipitative gout attack |
| Rare but serious SE of allopurinol use | hepatic necrosis, agranulocytosis |
| 3 drugs that increase Uric Acid excretion. Which is different and why? | Probenecid, sulfinpyrazone, Losartan; Losartan is an ATII Receptor antagonist |
| Pt with gout and HTN could possibly benefit from what drug | losartan |
| Pt’s taking penicillin must be careful of their blood concentration when taking what? | Probenecid and Sulfinpyrazone |
| To prevent kidney stones with probenecid used, what is given? | calium citrate or sodium bicarb to alkalinize the urine |
| This SE limits sulfinpyrazone | hematologic toxicity; also causes hypocoaguable state |
| Pt’s with RA must be careful with coadministration of probenecid and what drug? | methotrexate |
| MOA of rasburicase | enzyme from Aspergillus that turns Uric Acid to allantoin |
Created by:
csheck
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