Exam 2 thera gout

Question 1

Uric acid normal in male

Answer 1

5

Question 2

Normal uric acid in female

Answer 2

4

Question 3

Hyperuric acid in male

Answer 3

> 7

Question 4

Hyperuric acid in female

Answer 4

> 6

Question 5

Risk factors of acute gouty arthritis

Answer 5

-Alcohol
-Starvation
-Diuretics: Furosemide (Lasix) Torsemide (demadex) Bumetadine (Bumex)
-Low dose aspirin
-Rapid lowering uric acid levels -Allopurinol (zyloprim)
-Meat and seafood →Increases the risk
-Higher level of low fat dairy → Decreases the risk

Question 6

Interval gout

Answer 6

The time frame between a acute attack
The pt is classify as overproduce or underexcretion of uric acid

Question 7

Chronic tophaceous gout

Answer 7

deposit urate in the joints and develop tophi but is not painful

Question 8

Chronic tophaceous gout risk factors

Answer 8

-Chronic alcohol use
-Poor compliance
-Diuretic use
-Chronic renal insuffiency

Question 9

Acute gouty attack treatment

Answer 9

NSAID–>
Indomethacin (Indocin)
50mg QID or TID indomethacin (Indocin) for 2-3 days then 25mg TID or QID for 7-14 days until attack is resolve ,
or Naproxen
750mg x1 followed with 250mg TID
750mgx 1 500mg 8 hours later then 250mg q8 for 2-3 days
Sulindac 200mg PO BID
Colchine–>Colcy 1.2 mg followed by 0.6mg 1 hour lateer
Corticosteroid–>Prednisone (Deltasone)- only if the pt dont respond to NSAID therapy

Question 10

Interval gout

Answer 10

Is the time interval between an initial attack and a subsequent attack

Question 11

Interval gout therapy

Answer 11

Prophylactic therapy:
Colchine (colcy) 0.6mg QID or BID
NSAID:
Indomethacin 25mg BID
or
Naproxen 250mg BID

Question 12

Prophylactic therapy for prevention of further attacks

Answer 12

-Can be used in pt with severe attack of gouty arthritis
-Uric acid nephrolitis
-Elevated Serum uric acid levels

Question 13

Antihyperuricermic therapy is recommended

Answer 13

For pt that have recurrent attacks per year
-Have Chronic gouty joint disease
-See solid urate in joint see tophi
-Pt has nephrolithiasis

Question 14

Antihyperuricemic therapy
Uricosuric agentes Probenecid

Answer 14

-Needs to be underexcretion
-No history of neprholitis
Dose is 250mg BID and then 500mg BID then after 7 days 2g in 2 -4 doses
Side effects: GI, hypersensitive rxn

Benecid

Question 15

Antihyperurecimic therapy
Xanxine oxidase inhibitor

Allopurinol

Answer 15

-For underexcretion or overproduction
-Doses is 100mg QD then titrate to 300mg or 600mg qd
-If CrCl is 90-60 give 200mg qd
If CrCl is 60-30 give 100mg qd
-See response in 2 days but max is 7-10 days
-If pt has tophi because of chronic tophaceous gout give prophylaxis therapy until they are gone
-Continue therapy of prophyaxis for 3-6 months

Zylopirm

Question 16

Hyperurecemia therapy
Uloric (Febuxostat)

Answer 16

-Is a xanthidase oxidase inhibitor
-When pt does not tolerate allopurinol
-Dose is 40mg QD
-If no improvement in lowering the uric acid to 6 then increase the dose to 80mg QD

Drug interaction:
-Mercaptopurine
-Azathioprine
-Theophylline