07 gout Flashcards
1
Q
which gout med for prophylaxis? dose?
what to consider with this med? 4
A
Allopurinol mild 200-300mg 400-800 - mod to severe
1 multiple drug interactions
2 monitor uric acid levesl weekly until adequate dose, then q3mos for first year, then q6mos
3 give 1-2 weeks after inflammation (cause fluctuating SUA levels will destabilize crystals and make it worse) - can give nsaid and colchicine to help reduce flareup
4 initiate slowly, start 100mg/d for 2-4 weeks
2
Q
MOA of allopurinol?
SE - 4
A
Xanthine- oxidase inhibitor
inhibit uric acid synthesis by inhibiting xanthine oxidase
-lowers serum uric acid
SE - skin rashes - maculopapular
leukopenia
NV, D
precipitate gouty arthiritis
3
Q
meds to tx acute gout?
A
naproxen ibuprofen indomethacin celecoxib tylenol COLCHICINE 0.6mg BID x 3 days - metabolized by CYP3A4 - elevated colchicine levels if taking drugs that inactivate CYP3A4
4
Q
when is colchicine not recommended
A
after 36 hours of flare up
