| Question |
Answer |
| Gout S&S |
Sudden Onset. Monarticular - most common = MTP. Familial & associated with foods & drinks high in Purines (ETOH). Tophus - Crystals in joint. High Uric Acid level (Metabolic-overproduction or renal - underexcretion) |
| Gout Tx - Acute Arthritis |
NSAIDs (Indocin &/or COX-2 Inhibitor), Colchicine, Steroirds, Opiod & Bed Rest |
| Gout Tx - Hyperuricemia |
Colchicine, Probenecid & allopurinol |
| Gout Type - Metabolic |
Overproducer > 800mg uric acid in urine |
| Gout Type - Renal |
Underexcretion < 800 mg uric acid in urine |
| Colchicine MOA |
Decreases leukocyte motility, phagocytosis, & deposition of uric acid in joints. |
| Colchicine Pregnancy Category |
C |
| Colchicine Response time |
24-48 hours - oral & 6-12 hours IV. |
| Colchicine Contraindications |
Liver or Renal Dz. |
| Colchicine SE |
N/V, anorexia, diarrhea & allopecia |
| Colchicine decrease absorption... |
B12 |
| Colchicine avoid... |
Alcohol & ASA |
| Probenecid |
Benemid, Probalan |
| Probenecid (Benemid, Probalan) MOA |
Inhibits reabsorption of uric acid = increased excretion. |
| Probenecid (Benemid, Probalan) Form & Onset |
Tablet - 2 hours |
| Probenecid (Benemid, Probalan) Contraindications |
Children < 2 y.o., uric acid stones, Creatinine > 2mg/dl. |
| Probenecid (Benemid, Probalan) Pregnancy Category |
B |
| Probenecid (Benemid, Probalan) SE |
HA, Fever, Anorexia, Flushing, Itching, Renal Calculi & Leukopenia |
| Probenecid (Benemid, Probalan)avoid |
DM, ASA, PCN (penicillin) & Indocin |
| Allopurinol |
Zyloprim |
| Allopurinol (Zyloprim) MOA |
Inhibits Xanthine Oxidase - decrease uric acid production (Reduces uric acid without affecting purines & DNA synthesis) |
| Allopurinol (Zyloprim) Contraindications |
Acute gouty attack, allergy, pregnancy & lactation |
| Allopurinol (Zyloprim) Pregnancy Category |
C |
| Allopurinol (Zyloprim) Form & Onset |
Tablet: 1-2 days |
| Allopurinol (Zyloprim) SE |
Pruritic Rash, Vasculitis, hepatitis & drug rash with ampicillin. Drowsiness |
| Allopurinol (Zyloprim) affected by... |
alcohol decreases the effectivness |
| Febuxostat |
Uloric |
| Febuxostat (Uloric) MOA |
Inhibits Xanthine Oxidase - decrease uric acid production (Reduces uric acid without affecting purines & DNA synthesis) |
| Febuxostat (Uloric) Initially Response |
Increase gout flare ups |
| Febuxostat (Uloric) SE |
Cardiac/thrombolitic events, increases LFTs, Nausea & Rash |
| Febuxostat (Uloric) Pro vs. Allopurinol (Zyloprim) |
Less DI - None with Warfarin |
Amanda Leigh Brooks
on 2009-09-17
Ch.18 LTI-MA 509
