Drugs inflammatory and related disorder_ drugs used for Rx of Gout

Question 1

for Rx of acute inflammatory episodes of gout

Answer 1

NSAIDs are used as initial therapy for acute gout attack; colchicine and intra-articular steriods are alternative

Question 2

_____ binds to tubulin —> decrease microtubular polymerization, decrease LTB4, and decrease leukocyte and granulocyte migration

Answer 2

colchicine

Question 3

which drugs are used as alternative for acute gout

Answer 3

colchicine and intra-articular steriods

Question 4

side effects of colchicine

Answer 4

Acute: diarrhea, and GI pain

longer use: hematuria, alopecia, myelosuppression, gastritis, and peripheral neuropathy

Question 5

Prophylaxis of chronic gout are

Answer 5

allopurinol and febuxostat

Question 6

allopurinol and febuxostat drug strategy

Answer 6

reduction of uric acid pool (decreases uric acid formation)

Question 7

mechanism of actions of allopurinol and febuxostat

Answer 7

inhibits Xanthine Oxidase —> decrease purine metabolism —> decrease uric acid; also useful in cancer chemotherapy and radiation

Question 8

side effects of allopurinol and febuxostat

Answer 8

rash, hypo [xanthine) stones

Question 9

Drug interactions of allopurinol and febuxostat

Answer 9

inhibits 6-Mercaptopurine (6-MP) metabolism

Azathioprine —-> 6-MP(inactive) —HGPRT—-> 6-MP (active) —–XO (xanthine oxidase-inhibited by allopurinol)—-> inactive

Question 10

________ is recombinant urate-oxidase enzyme for the preventation of tumor lysis syndrome

Answer 10

Rasburicase

Question 11

________ reduces serum uric acid

Answer 11

Rasburicase

Question 12

________ recombinant urate-oxidase enzyme for refractory gout; metabolizes uric acid to allantoin —> decrease plasma uric acid

Answer 12

Pegloticase

Question 13

Pegloticase side effects are

Answer 13

anaphylaxis; urticaria (hives, wheals-pale red bumps, plaques)

Question 14

what metabolizes uric acid to allantoin —> decrease plasma uric acid

Answer 14

Pegloticase

Question 15

______ inhibits proximal tubular reabsorption of urate but ineffective if GFR <50 ml/min

Answer 15

Probenecid

Question 16

Probenecid is ineffective if _______

Answer 16

GFR <50 ml/min

Question 17

drug interactions of Probenecid

Answer 17

inhibits the secretion of weak acid drugs such as penicillins, cephalosporins and fluroquinolones

Question 18

inhibits the secretion of weak acid drugs such as penicillins, cephalosporins and fluroquinolones

Answer 18

Probenecid

Question 19

mechanism of action of allopurinol

Answer 19

Allopurinol —Xanthine oxidase——>Alloxanthine, which inhibits Xanthin Oxidase along Febuxostat in this synthesis:
Purine —-> hypoxanthine – xanthine oxidase (inhibited by allopurinol)–>xanthine —-Xanthine oxidase (inhibited by allopurinol and Febuxostat)—-> uric acid