Gout Flashcards
Which drugs increase uric acid
aspirin, calcinurin inhibitors (tacrolimus and cyclosporine), diuretics (loop and thiazides), niacin, pyrazinamide, some chemptherapy drugs with chemo lysis syndrome, pancreatic enzyme products
colcrys/colchisine dosing and when to start and resume prophylaxis dosing
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
colrys/colchisine contraindications
pgp or cyp inhibition
colcrys/colchisine side effects
gi symptoms, myopathy, myelosupression, neuropathy
Indocin
Indomethacin
Aleve
Naproxen
Celebrex
Celecoxib
Prednisilone
Prednisone
Medrol
Methylprednisone
side effects of steroids
increased blood glucose, blood pressure and appetite and insomnia
Methylprednisone gets delivered how
intramuscularly directly in joints
contraindications for nsaids
CVD and severe renal disease
What can be used for acute gout attack
NSAID, colchisne, steroids
UA goal for prophylaxis
<6mg/dL
gout prophylaxis treatment algorithm
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)
When would febucostat be used
only when allopurinol is not tolerated (such as in hypersensitivity)
Which foods to avoid in gout
organ meats, high fructose corn syrup, alchohol
Zyloprim
Allopurinol
Alloprim
Allopurinol
Allopurinol warnings
hypersensitivity reactions including severe rash due to HLA-B 5801 testing prior to use (esp asians) and hepatotoxicity
moa of uricosurics
Lesinurad and probenecid - inibit resorption of uric acid in the kidneys
what is probenecid used for
to increase uric acid levels
boxed warning for peglitocase
anaphylactic reactions - monitor and premedicate with antihistamines and steroids
contraindications for pedlitocase
G6P6 deficiency
