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Pharm 47 Gout

LECOM Pharm Ch 47 Integrated Gout

Treat Acute Gout with what 3 classes of drugs NSAIDS; colchicine; glucocorticoids
Treat Chronic gout with what 3 drugs Allopurinol; Probenecid; Sulfinpyrazone
MOA of colchicine inhibits microtubule formation
Colchicine commonly causes this SE Diarrhea
2 more sever SE of colchicine myelosupression, neuromyopathy
3 drugs that can cause toxic blood levels of colchicine cyclosporine, tacrolimus, verapamil
NSAID used commonly in gout indomethacin
This can be injected into a gouty joint methylprednisolone
MOA of Allopurinol oxidized to oxypurinol and then inhibits molybdenum oxidative state conversion in xanthine oxidase; decreasing uric acid synthesis
Blood levels of what 2 metabolites increase with allopurinol use 2 xanthine and hypoxanthine
Cancer or transplant recipients can have toxic levels of what 2 drugs when used with Allopurinol azathioprine and mercaptopurine
When a Pt presents with polyarticular gout and renal insufficiency, what can be used as an antiinflamitory agent? Glucocorticoids
Cochicine used an lower what product of arachadonic acid LTB4
If a Pt starts taking allopurinol and develops a skin rash, why is the drug stopped? Possibility of developing Stephen-Johnson Syndrome
When first starting allopurinol treatment, what else should the Pt be given and why? Either colchicine or an NSAID to prevent initial precipitative gout attack
Rare but serious SE of allopurinol use hepatic necrosis, agranulocytosis
3 drugs that increase Uric Acid excretion. Which is different and why? Probenecid, sulfinpyrazone, Losartan; Losartan is an ATII Receptor antagonist
Pt with gout and HTN could possibly benefit from what drug losartan
Pt’s taking penicillin must be careful of their blood concentration when taking what? Probenecid and Sulfinpyrazone
To prevent kidney stones with probenecid used, what is given? calium citrate or sodium bicarb to alkalinize the urine
This SE limits sulfinpyrazone hematologic toxicity; also causes hypocoaguable state
Pt’s with RA must be careful with coadministration of probenecid and what drug? methotrexate
MOA of rasburicase enzyme from Aspergillus that turns Uric Acid to allantoin
Created by: csheck