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Pharmacology
Gout
Question | Answer |
---|---|
Antigout drugs mechanism | reduce inflammatory process,or prevent synthesis of uric acid |
Inhibit xanthine oxidase, the enzyme responsible for the conversion of hypoxanthine and xanthine to uric acid | Allopurinol (Zyloprim), febuxostat (Uloric) |
The only drugs that act on the pathophysiological cause of gout | Allopurinol (Zyloprim), febuxostat (Uloric) |
Goal is to have uric acid less than | 6mg/dL |
Binds to microtubular proteins to interfere with the function of the mitotic spindles and inhibit the migration of granulocytes to the inflamed area | Colchicine |
actions decrease the inflammatory response to the deposited urate crystals | Colchicine |
not uricosuric and does not prevent gout from progressing to chronic gouty arthritis | Colchicine |
Increase the rate of uric acid secretion | uricosuric drugs |
uricosuric drugs | probenicid, sulfinpyrazone |
Sulfa based and should not be used in the case of sulfa allergy | uricosurics |
contraindicated in patients taking drugs requiring xanthine oxidase (Imuran, mercaptopurine, theophylline) | Febuxostat (Uloric) |
associated with maculopapular skin rash, scaly, exfoliative, drug should be discontinued | Allopurinol (Zyloprim) |
induces reversible malabsorption of B12 | colchicine |
Antigout drugs mechanism | reduce inflammatory process,or prevent synthesis of uric acid |
Inhibit xanthine oxidase, the enzyme responsible for the conversion of hypoxanthine and xanthine to uric acid | Allopurinol (Zyloprim), febuxostat (Uloric) |
The only drugs that act on the pathophysiological cause of gout | Allopurinol (Zyloprim), febuxostat (Uloric) |
Goal is to have uric acid less than | 6mg/dL |
Binds to microtubular proteins to interfere with the function of the mitotic spindles and inhibit the migration of granulocytes to the inflamed area | Colchicine |
actions decrease the inflammatory response to the deposited urate crystals | Colchicine |
not uricosuric and does not prevent gout from progressing to chronic gouty arthritis | Colchicine |
Increase the rate of uric acid secretion | uricosuric drugs |
uricosuric drugs | probenicid, sulfinpyrazone |
Sulfa based and should not be used in the case of sulfa allergy | uricosurics |
contraindicated in patients taking drugs requiring xanthine oxidase (Imuran, mercaptopurine, theophylline) | Febuxostat (Uloric) |
associated with maculopapular skin rash, scaly, exfoliative, drug should be discontinued | Allopurinol (Zyloprim) |
induces reversible malabsorption of B12 | colchicine |
treatment of acute gouty attacks | colchicine initial dose 1.2mg, followed by 0.6 mg one hour later, symptoms usually resolve in 24-48 hours |
preventive therapy with colchicine | 0.6mg/day 3-4x/week if pt has fewer than one attack per year; 0.6 daily for more frequent attacks |
drug of choice for h/o urinary calculi, renal insufficiency, chronic tophaceous gout, or high levels of serum urate | allopurinol, mild 200-300 mg/day; moderate 400-600mg/day. Minimum dose 100-200; Maximum dose, 800. Doses > 300 must be divided |
best for pts who overproduce uric acid | allopurinol (Zyloprim), febuxostat (Uloric) |
best for pts who undersecrete uric acid | probenecid |
toxicity seems more likely when allopurinol is given concomitantly with | thiazide diuretics |