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DCPA Gout Pharm

QuestionAnswer
Gout S&S Sudden Onset. Monarticular - most common = MTP. Familial & associated with foods & drinks high in Purines (ETOH). Tophus - Crystals in joint. High Uric Acid level (Metabolic-overproduction or renal - underexcretion)
Gout Tx - Acute Arthritis NSAIDs (Indocin &/or COX-2 Inhibitor), Colchicine, Steroirds, Opiod & Bed Rest
Gout Tx - Hyperuricemia Colchicine, Probenecid & allopurinol
Gout Type - Metabolic Overproducer > 800mg uric acid in urine
Gout Type - Renal Underexcretion < 800 mg uric acid in urine
Colchicine MOA Decreases leukocyte motility, phagocytosis, & deposition of uric acid in joints.
Colchicine Pregnancy Category C
Colchicine Response time 24-48 hours - oral & 6-12 hours IV.
Colchicine Contraindications Liver or Renal Dz.
Colchicine SE N/V, anorexia, diarrhea & allopecia
Colchicine decrease absorption... B12
Colchicine avoid... Alcohol & ASA
Probenecid Benemid, Probalan
Probenecid (Benemid, Probalan) MOA Inhibits reabsorption of uric acid = increased excretion.
Probenecid (Benemid, Probalan) Form & Onset Tablet - 2 hours
Probenecid (Benemid, Probalan) Contraindications Children < 2 y.o., uric acid stones, Creatinine > 2mg/dl.
Probenecid (Benemid, Probalan) Pregnancy Category B
Probenecid (Benemid, Probalan) SE HA, Fever, Anorexia, Flushing, Itching, Renal Calculi & Leukopenia
Probenecid (Benemid, Probalan)avoid DM, ASA, PCN (penicillin) & Indocin
Allopurinol Zyloprim
Allopurinol (Zyloprim) MOA Inhibits Xanthine Oxidase - decrease uric acid production (Reduces uric acid without affecting purines & DNA synthesis)
Allopurinol (Zyloprim) Contraindications Acute gouty attack, allergy, pregnancy & lactation
Allopurinol (Zyloprim) Pregnancy Category C
Allopurinol (Zyloprim) Form & Onset Tablet: 1-2 days
Allopurinol (Zyloprim) SE Pruritic Rash, Vasculitis, hepatitis & drug rash with ampicillin. Drowsiness
Allopurinol (Zyloprim) affected by... alcohol decreases the effectivness
Febuxostat Uloric
Febuxostat (Uloric) MOA Inhibits Xanthine Oxidase - decrease uric acid production (Reduces uric acid without affecting purines & DNA synthesis)
Febuxostat (Uloric) Initially Response Increase gout flare ups
Febuxostat (Uloric) SE Cardiac/thrombolitic events, increases LFTs, Nausea & Rash
Febuxostat (Uloric) Pro vs. Allopurinol (Zyloprim) Less DI - None with Warfarin
Created by: 147401391
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