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Pharmacology

Gout

QuestionAnswer
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
Created by: heatherbrown2020