Drug Treatment of Gout

Question 1

Colchicine MOA (5):

Answer 1

• Decreased leukocyte mobilization
• Decreased lactic acid production
• Decreased histamine from mast cells
• Decreased release of inflammatory glycoprotein from neutrophils
• Inhibition of leukotriene synthesis

Question 2

Colchicine chronic use (4):

Answer 2

• Increased risk of aplastic anemia
• Agranulocytosis
• Myopathy
• Alopecia

Question 3

Allopurinol MOA:

Answer 3

Inhibits the enzyme xanthine oxidase to decrease UA formation

Question 4

Allopurinol and 6-MP:

Answer 4

Dose of 6-MP should be reduced

Question 5

Febuxostat MOA:

Answer 5

Inhibition of Xanthine Oxidase.

Question 6

Febuxostat pharmacokinetics:

Answer 6

Absorption reduced by magnesium hydroxide and aluminum hydroxide antacids.

Question 7

Febuxostat toxicity:

Answer 7

Liver function abnormalities, nausea, joint pain and rash.

Question 8

Rasburicase MOA:

Answer 8

Recombinant urate oxidase enzyme that catalyzes the oxidation of uric acid into soluble alloantoin

Question 9

Rasburicase Toxicity (4):

Answer 9

• Hemolysis in GGPD deficient pts
• Methemoglobinemia
• Acute renal failure
• Anaphylaxis

Question 10

Uricosuric agents (2):

Answer 10

• Probenecid

- Sulfinpyrazone

Question 11

Probenecid MOA:

Answer 11

Competitively inhibit active reabsorption of urate by primarily URAT-1 in the proximal tubule of the nephron to increase urate excretion

Question 12

Probenecid toxicity:

Answer 12

GI irritation with aggravation of peptic ulcer

Question 13

To minimize interarenal urate stone formation by probenecid (2):

Answer 13

• Fluid intake should be increased

- Urine can be alkalinized (bicarb)

Question 14

Benzbromarone:

Answer 14

Increases urate excretion without urate retention.