final lecture 4

Question 1

general treatment principles for gout

Answer 1

terminate an acute attack
prevent recurrent attacks
prevent complications associated w/ crystals in tissues
minimize drug side effects

Question 2

non-pharmacologic modalities

Answer 2

local, topical cold therapy, weight reduction, decrease alcohol, dietary changes, time

Question 3

1st line therapy for gout attack

Answer 3

NSAIDs

Question 4

2nd line therapy for gout attack

Answer 4

colchicine

give <36 hours after attack

Question 5

colchicine dose

Answer 5

2ts at onset, 1 tab 1 hour later then 0.6mg PO QD-BID 12 hours later

Question 6

most common side effect of colchicine

Answer 6

diarrhea

Question 7

complete resolution of gout symptoms w/ colchicine in

Answer 7

24-48 hours

many w/ relief in a few hours

Question 8

last line therapy for gout attack

Answer 8

corticosteroids & opiods

Question 9

consider gout prophylaxis if

Answer 9

the pt had severe attack, nephrolithiasis w/ attack, serum urate >10, 24 hr urinary excretion of urate >1000mg, tophi present 2+attacks/yr, renal dysfunction

Question 10

treatment principles for gout prophylaxis

Answer 10

urate<6

Question 11

1st line gout prophylaxis

Answer 11

colchine or NSAIDs

Question 12

colchicine prophylaxis dose

Answer 12

0.6mg PO QD-BID

CI if CrCl<10

Question 13

duration of anti-inflammatories for gout prophylaxis

Answer 13

at least 6 months

Question 14

drug of choice for overproducers

Answer 14

xanthine oxidase inhibitors- allopurinol or febuxostat

Question 15

allopurinol dose

Answer 15

100mg PO QD

Question 16

tumor lysis syndrome in peds pts

Answer 16

rasburicase