Drugs to Treat Gout Flashcards
Describe the pathophysiology of gout with related clinical signs and symptoms.
Gout is a form of ARTHRITIS which is caused by the accumulation of uric acid crystals in joints - particulary the big toe. A metabolic dysfunction in which there is deposition of uric acid in and around joints causing severe pain, inflammation/swelling, and restricted mobility.
Discuss the mechanism of action of colchicine (Colcrys)
One Indication Only: Tx of ACUTE Gout. MA: Inhibition of Nutrophil migration/phagocytic activity in inflammed joints which in turn prevents release of degradative lysosomal enzymes in to ECF. SE: GI toxicity (NVD), marrow deprssion, myopathy, alopecia.
Discuss the mechanism of action of allopurinol (Zyloprim)
Indications: Management of Chronic Gout. Prevent formation of excessive uric acid - lower blood and urine levels of uric acid. NOT indicated for Asymptomatic Hyperuricemia. Also used during Chemotherapy/Radiation Tx to counteract effect of increased purines in serum. SE: Hepatotoxic, Pruritic Rash, Allergic skin and Blood reactions.
Discuss the mechanism of action of probenecid (Benemid)
Indications: Management of Chronic Gout. Indicated when actute gout attacks increase in frequency or severity. MA: Increases excretion of Uric Acid = Uricosuric Agent – Blocks tubular reabsorption of filtered urate, increasing urinary excretion of uric acid and plasma urate concenctrations. Mobilizes current tophi and prevents formation of new tophi. SE: GI, headaches, sore gingiva. May lead to urate stones in the kidneys.
Discuss common side effects associated with medications used to treat gout.
GI disorders - Nausea, Vomitting, Diarrhea (NVD). Headache, allergic reactions.
Identify non-opioid pain relievers that may be used in the management of gout.
Short-term use during Acute Episodes: Indomethacin, Naproxen, Sulindac. Relieve pain/tenderness/swelling of affected joints = no mechanism againts gout itself. **Low dose Aspirin interferes with Uricosuric action of probenecid - may decrease urate excretion. **Probenecid increases the plasma level of Penicillin because probenecid is selectively filtered first by the kindneys. Probenecid + Penicillin = Augmentin.
