Anti Gout And Anti Rheumatics Flashcards
Accelerating renal excretion of uric acid with uricosuric drugs
Probenecid, sulfinpyrazone
Reduce inflammation during Acute attacks
Nsaids, glucocorticoids
Reduce conversion of purines to uric acid
Allopurinol
Nsaids
Fewer git complaints except indometh
Indomethacin
Naproxen
Sulindac
Monoarticular cortico
Intraarticular
Triamcinolone
Polyarticular cortico
Intravenous-Methylprednisolone
Oral- prednisone
Colchicine
For Acute gout
Moa colchicine
Dec lactic acid Dec kinin formation Dec inhib phagocytosis Inhib migration Block lipoxygenase pathway
Adverse effects of colchicine
Earliest signs of impending toxicity
Diarrhea, nausea, vomiting, abs pain
Warning colchicine
Pregnancy: category c
Moa probenecid
Dec tubular reabsorption of urate
Inc excretion of uric
Dec serum uric acid
Probenecid indication
Recurrent attacks
Start 2-3 weeks after
Adverse effects probenecid
Cns stimulation, convulsion, respi fail
Moa allopurinol
Inhib xanthine oxidase
Metab to oxypurinol- also inhib
Drob levels by day 2-3
Indication allopurinol
Chronic tophaceous gout
Ae allopurinol
Toxic epidermal necrolysi: SJS- first 2 mos treatment
Drug interactions allopurinol
Probenecid-inc half life Mercaptopurine- inhib activation Cyclophosphamide- bone m. Suppression Warfarin- interferes with inactivation Ampicillin- rash Theophylline- inc metab
Prodrome Rheuma arthritis
Malaise
Fever
Weight loss
Morning stiffness
Progression ra
Centripetal, symmetric
Anti-ra
Antiinflamm
Dmards-slow acting
Glucocorticoids
Used chronically for patients with uncontrollable ra
Doc ra
Acetyl salicylic acid
Aspirin
Slow acting anti- ra
Hydroxychloroquine sulphate
Azathioprine
Moa hydroxychloroquine sulfate
Suppression of formation of antigen
Interactions
Inc digoxin
Inc dermatitis with gold compounds
Gold compounds
Does not cure
Moa: inhib phago, inhib lysosomal enzyme
Do not use with: penicillamine, anti malarial, hydro.., methotrexate, cyclophosphamide, azathioprine
Methotrexate
Inhib dna precursor uptake
Pregnancy category x
Penicillamine
Severe ra
Ae: oral ulcer, losso f taste, fever rash,
Sulfasalazine
Neutropenia, thrombocytopenia