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antiinflammatory med
Antiinflammatory medications & concepts
Question | Answer |
---|---|
NSAID use in Gout | for acute tx; CI with renal insufficiency, heart failure, peptic ulcers, or allergies; first line for acute; pain relief in 1-2 days. Avoid aspirin. |
Glucocorticoids use in gout | 2nd line for acute; must taper off (rebound gout); |
Colchicine use, CI's, ADE's; | 2nd line for acute/chronic gout; dose: 1.2 mg po at onset, then 0.6 mg one hour later; renally dose; CI with CYP3A4 inh; ADE: diarrhea, N/V, ab pain; may cause myopathy & myelosupression if used long term (prophylactically); |
Allopurinol | Xanthine oxidase inhibitor used for gout; works for under/overexcreter's; titrate up 100mg/w; ADE: rash, leukopenia, GI, fever, thrombocytopenia, acute gout; take w/food; hypersensitivity; less LFT's; |
Febuxostat | non-purine xanthine oxidase inhibitor used in gout;less hypersensitivity; no dose adj. in renal impair.; ADE: diarrhea, ab pain, inc. LFT's; some rashes; costly |
Probenecid | uricosuric agent; increases excretion of urates in gout; ADE: GI, rash, hypersensitivity, acute gout, uric acid kidney stones; consume 2L fluids daily; CI in CrCl < 50; |
Pegloticase (krystexxa) | uricase that breaks down uric acid crystals in gout; IV infusion q2w; costly; ADE: n/v, inj. rxn, acute gout, constipation; CI in genetic deficiency (G6PD), forms antibody response; |