Drugs for gout & arthritis Flashcards
Drugs for osteoarthritis
- Paracetamol
- Intra-articular: hyaluronic acid
- NSAIDs: naproxen, diclofenac, coxibs
- Corticosteroid: prednisolone
MOA of hyaluronic acid
- reduces pain & stiffness
- shock absorption
- induces biosynthesis of HA & extracellular matrix
- lubrication
- protective coating of cartilage
Drugs for gout
ACUTE:
- Colcihine (for ACUTE)– most effective in gout
- NSAIDs- Indometacin, Naproxen, Celecoxib, Etoricoxib
- Corticosteroid- prednisolone
Prevention:
1. Allopurinol (1st line) (for hyperuricemia)
2. Probenecid
(for hyperuricemia)
Colcihine MOA
- Binds __________
- Prevent __________ into microtubules
- Inhibits __________ & __________
- Inhibits _________ and __________production
- Binds tubulin
- Prevent tubulin polymerization into microtubules
- Inhibits leukocyte migration & phagocytosis
- Inhibits leukotriene B4 (LTB4) and prostaglandin production
Colcihine works within ______ hrs
24-36
Colcihine side effects
Diarrhoea Nausea Vomiting Abdominal pain Muscle weakness Unusual bleeding Pale lips Change in urine amount
Allopurinol MOA
- Inhibit __________
- Decrease __________
- Therapeutic target: __________
- Inhibit uric acid synthesis
- Decrease uric acid production
- Therapeutic target: <6.0mg/dL
Allopurinol side effects
Skin rash Nausea Vomiting Diarrhoea Fever Sore throat Stomach pain Dark urine Jaundice
Allopurinol: can start during acute attack?
NOOOOO
Allopurinol severe effects
- Allopurinol hypersensitivity syndrome (AHS)
2. Severe cutaneous adverse reaction (SCAR)
Probenecid MOA
- Inhibits ________________
- Inhibits ________________
- Increases ________________
- Inhibits proximal tubule anion transport
- Inhibits uric acid re-absorption
- Increase uric acid excretion
Probenecid: start ___ wks after an acute attack
2-3
Probenecid side effects
Nausea Vomiting Painful urination Lower back pain Allergic reactions Rash
Probenecid: Do NOT use during _____ attack when plasma urate ↑ mobilisation from joints
acute
Probenecid: Take plenty fluid & keep urine pH>__ to reduce risk of _________
pH>6
uric acid nephrolithiasis
ALL gout & arthritis can use ____ and ____
NSAIDs & corticosteroids
NSAIDs treat ___ attacks
acute
NSAIDs inhibit the production of _________ & _________
prostaglandins and urate crystal phagocytosis
NSAIDs examples—
Non-selective COX inhibitors: _______, _______
Selective COX inhibitors: _______
Non-selective COX inhibitors: naproxen, indometacin
Selective COX inhibitors: celecoxib
Contraindications of NSAIDs
OA: increase bleeding while on anticoag/anti-platelet
Gout: Low-dose aspirin, salicylates
Diclofenac (NSAID) is preferable for ______
mild osteoarthritis
Corticosteroids example
prenisolone
