Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
BCPS study guide
gout
| Question | Answer |
|---|---|
| what serum urate level indicates gout | >6.8 mg/dL |
| why don't you want to try to diagnose gout using serum urate levels during a flare. when is a better time. what is a better diagnostic method and why isnt it used more | because serum uric acid is low during a flare, you should check ~2 weeks after a flare. better to do a joint aspirate during a flare but patients typically won't allow this. |
| options for monotherapy treatment of acute gout attacks | NSAIDs, colchicine, oral corticosteroids. can try intra-articular steroids or IM triamcinolone if 1 or more large joints are involved. ACTH is also an option if patient can't take oral meds |
| options for combination therapy treatment of acute gout attacks | colchicine and NSAIDS; colchicine and oral corticosteroids; intra-articular steroids and [colchicine, NSAIDS or oral corticosteroids. |
| indications for urate lowering therapy | tophi by exam or imaging, 2 or more gouty attacks per year, CKD stage 2 or greater, past urolithiasis, |
| first line for chronic urate lowering therapy | xanthine oxidase inhibitor - i.e. allopurinol or febuxastat |
| alternative agents for chronic urate lowering therapy | probenecid, losartan, fenofibrate |
| when is it not appropriate to use probenecid as an alternative to xanthine oxidase inhibtors for suppression of gout | CrCl <50 or a history of urolithiasis |
| What are risk factors for allopurinol hypersensitivity syndrome | thiazides, decreased renal function and ethnic factors |
| what should you expect to see in patients who are started on urate lowering therapy and how should you treat this | after initiation of urate lowering therapy, expect to see an increase in gout flares. use prophylaxis to deal with this. colchicine, NSAIDs + PPI, or oral corticosteroids. start within 36 hours of flare. |
| if persistent hyperuricemia occurs despite treatment with standard therapies what can you add and what precautions are necessary | pegloticase can be started but all other gout meds must be stopped. causes hypersensitivity, pretreat with antihistamine and steroids |
| what NSAIDS are approved for use in gout | naproxen, sulindac and indomethacin |
Created by:
mjuhlin
Popular Pharmacology sets