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