Drugs Used for Treatment of Gout

Question 1

What is the best initial therapy for treatment of acute gout attacks?

Answer 1

NSAIDs

Question 2

What are alternatives to using NSAIDs for best treatment for acute gout attacks?

Answer 2

colchicine and intra-articular steroids

Question 3

MOA colchicine?

Answer 3

binds to tubulin > dec micro tubular polymerization, > dec LTB4 and dec. leukocyte and granulocyte migration

Question 4

What are the side effects of using colchicine?

Answer 4

diarrhea and GI pain, hematuria, alopecia, myelosuppression, gastritis, and peripheral neuropathy

Question 5

Chronic gout prophylactic medications that reduce the uric acid production.

Answer 5

allopurinol and febuxostat

Question 6

MOA of allopurinol? What other indications besides gout treatment does it have?

Answer 6

inhibit XO > dec. purine metabolism > dec uric acid (also useful in cancer chemotherapy and radiation)

Question 7

What are some important drug interactions to note when taking allopurinol or febuxostat?

Answer 7

inhibits 6 mercaptopurine (6-MP) metabolism

Question 8

Pegloticase MOA? Indications?

Answer 8

recomibinant urate oxidase enzyme for refractory gout; metabolizes uric acid to allantoin > dec plasma uric acid

Question 9

What are the side effects of pegloticase?

Answer 9

anaphylaxis, urticaria

Question 10

What are the side effects of allopurinol/ febuxostat?

Answer 10

rash, hypo[xanthine] stones

Question 11

MOA of Probenecid.

Answer 11

inhibits proximal tubular reabsorption of urate

Question 12

What are important drug interactions you must remember when prescribing probenecid?

Answer 12

inhibits secretion of weak acid drugs such as pens, cephalosporins, and fluoroquinolones