Ch 74 Gout

Question 1

__ is an inflammatory disorder characterized by hyperuricemia and episodic joint pain, typically in the big toe.

Answer 1

Gout

Question 2

(2) are preferred drugs for treating acute gouty attacks.

Answer 2

NSAIDs and glucocorticoids

Benefits derive mainly from antiinflammatory actions.

Question 3

__ is a second-choice drug for treating an acute gouty attack.

Answer 3

Colchicine

Question 4

Four drugs are used long term to prevent gouty attacks:

Answer 4

allopurinol, febuxostat, probenecid, and pegloticase

Benefits derive from lowering plasma uric acid levels. These drugs lack anti-inflammatory and analgesic actions, and hence are not effective against acute gouty attacks.

Question 5

__ is the drug of choice for urate-lowering therapy (ULT).

Answer 5

Allopurinol

Question 6

Allopurinol lowers plasma uric acid by __.

Answer 6

decreasing uric acid production.

Allopurinol inhibits xanthine oxidase, an enzyme that forms uric acid from breakdown products of DNA.

Question 7

Probenecid lowers plasma uric acid by __.

Answer 7

promoting renal uric acid excretion, through inhibition of tubular reabsorption of uric acid.

Question 8

__ is indicated as ULT for patients refractory to conventional treatment (e.g., allopurinol, probenecid).

Answer 8

Pegloticase

Question 9

Pegloticase lowers plasma uric acid by __.

Answer 9

promoting uric acid breakdown.

Pegloticase is an enzyme that converts uric acid to allantoin, a water-soluble compound that is readily excreted by the kidney.

Question 10

__ accelerates uric acid removal in hyperuricemia that occurs as a consequence of cancer chemotherapy.

Answer 10

Rasburicase