Gout

Question 1

Which drugs increase uric acid

Answer 1

aspirin, calcinurin inhibitors (tacrolimus and cyclosporine), diuretics (loop and thiazides), niacin, pyrazinamide, some chemptherapy drugs with chemo lysis syndrome, pancreatic enzyme products

Question 2

colcrys/colchisine dosing and when to start and resume prophylaxis dosing

Answer 2

two 0.6 tablets followed by 0.6 mg in 1 hour (1.8 mg in 1 hour max)

start within 36 hours of symptom onset and wait 12 hours after a treatment dose before resuming prophylaxis

Question 3

colrys/colchisine contraindications

Answer 3

pgp or cyp inhibition

Question 4

colcrys/colchisine side effects

Answer 4

gi symptoms, myopathy, myelosupression, neuropathy

Question 5

Indocin

Answer 5

Indomethacin

Question 6

Aleve

Answer 6

Naproxen

Question 7

Celebrex

Answer 7

Celecoxib

Question 8

Prednisilone

Answer 8

Prednisone

Question 9

Medrol

Answer 9

Methylprednisone

Question 10

side effects of steroids

Answer 10

increased blood glucose, blood pressure and appetite and insomnia

Question 11

Methylprednisone gets delivered how

Answer 11

intramuscularly directly in joints

Question 12

contraindications for nsaids

Answer 12

CVD and severe renal disease

Question 13

What can be used for acute gout attack

Answer 13

NSAID, colchisne, steroids

Question 14

UA goal for prophylaxis

Answer 14

<6mg/dL

Question 15

gout prophylaxis treatment algorithm

Answer 15

Treat with an XOI and if UA still not below 6 then can add on probenecid or lesinurad or replace XOI with IV peglitocase (krystexxa)

Question 16

When would febucostat be used

Answer 16

only when allopurinol is not tolerated (such as in hypersensitivity)

Question 17

Which foods to avoid in gout

Answer 17

organ meats, high fructose corn syrup, alchohol

Question 18

Zyloprim

Answer 18

Allopurinol

Question 19

Alloprim

Answer 19

Allopurinol

Question 20

Allopurinol warnings

Answer 20

hypersensitivity reactions including severe rash due to HLA-B 5801 testing prior to use (esp asians) and hepatotoxicity

Question 21

moa of uricosurics

Answer 21

Lesinurad and probenecid - inibit resorption of uric acid in the kidneys

Question 22

what is probenecid used for

Answer 22

to increase uric acid levels

Question 23

boxed warning for peglitocase

Answer 23

anaphylactic reactions - monitor and premedicate with antihistamines and steroids

Question 24

contraindications for pedlitocase

Answer 24

G6P6 deficiency

Question 25

xoi major DDI

Answer 25

mercatopurine, the active metabolite of azithioprine

Question 26

What is resburicase used for

Answer 26

the treatment of tumor lysis syndrome

Question 27

rasburicase contraindication

Answer 27

g6pd deficiency