Drugs for Gout Flashcards
What drug is the treatment option for Hyperparathyroidism?
Cinacalcet
What does Cinacalcet treat?
Hyperparathyroidism
What is the MOA for Cinacalcet?
Increases PTH receptors sensitivity to calcium in order to decrease PTH secretion
What is the treatment for Osteoarthritis?
NOTHING slows or reverses it
If an Osteoarthritis patient wants pain relief, what are some of their options?
- topical NSAID (1% diclofenac gel)
- SNRI (duloxetine)
In the treatment of Osteomyelitis, what should you do first?
ID the pathogen
What are some antibiotics (4) that are given for Osteomyelitis and for how long?
- 4-6 weeks
- Clindamycin
- Rifampin
- TMP-SMX
- Fluoroquinolones
What are 3 NSAIDs that can be used for Gout and what do they inhibit?
Naproxen - (-) COX
Indomethacin - (-) COX1
Celecoxib - (-) COX2
What are 2 Xanthine Oxidase (-)’s for Gout?
Allopurinol
Febuxostat
What are 2 Xanthine Oxidase (-)s for Gout?
Allopurinol
Febuxostat
What are 2 Uricosurics for Gout?
Probenecid
Sulfinpyrazone
What are 2 Uricosurics for Gout?
Probenecid
Sulfinpyrazone
What are 2 Recombinant Uricase forms to treat Gout?
Pegloticase
Rasburicase
What are 2 Recombinant Uricase forms to treat Gout?
Pegloticase
Rasburicase
What is 1 microtubule formation disrupter to treat gout?
Colchicine
For Acute Gout, what is the order of what should be given?
NSAIDS
Colchicine – (-) microtubule formation
Glucocorticoids
For Acute Gout, what is the order of what should be given?
NSAIDS
Colchicine – (-) microtubule formation
Glucocorticoids
For Established Gout, what are non-pharmacologic things to do?
Decrease diet, weight and alcohol
For Established Gout, what are the first line agents?
Allopurinol
- Febuxostat
- Uricosuric
For Established Gout, what are the first line agents?
Allopurinol
- Febuxostat
- Uricosurics
What is the last line agent for Established Gout?
Pegloticase
What is a competitive inhibitor of Xanthine Oxidase?
Allopurinol
What is a potentially serious adverse effect of Allopurinol and what HLA increases your risk?
Hypersensitivity reaction
– HLA-B*5801
What are some common (3) side effects of Allopurinol?
Skin rash
Gout
Increased liver enzymes
What is a NON-competitive inhibitor of Xanthine Oxidase?
Febuxostat
When should Febuxostat be used?
When Allopurinol is not tolerated
What is a con of Febuxostat?
Expensive
What do Xanthine Oxidase (-)’s cause to be excreted?
Hypoxanthine and Xanthine
What is the MOA for the Uricosurics and what are they?
- Probenecid
- Sulfinpyrazone
= organic acids that (-) urate reabsorption»_space; urate secretion
Organic acids that (-) urate reabsorption
Uricosurics
= Probenecid and Sulfinpyrazone
What drugs decrease the plasma concentration of Urate?
Probenecid and Sulfinpyrazone
What drug can promote urate reabsorption (bad)?
Aspirin
What drug is attached to Methoxy Polyethylene Glycol?
Pegloticase
MOA for Pegloticase and Rasburicase?
Convert Uric acid to Allantoin (soluble form)
What can occur with Pegloticase?
Infusion reactions
What drug prevents uric acid nephropathy due to tumor lysis syndrome in patients with high risk lymphoma/leukemia?
Rasburicase
MOA for Probenecid and Sulfinpyrazone?
Organic acids that (-) urate reabsorption to decrease urate
MOA for Pegloticase and Rasburicase?
Convert uric acid to Allantoin (soluble form)
What is the MOA for Colchicine?
(-) Microtubule formation
____ are degraded to uric acid with Gout
Purines