Gout

Question 1

3 drugs for acute gout attack

Answer 1

NSAIDS
Glucocorticoids
Colchicine

Question 2

Causes of Gout

Answer 2

1. increase uric acid PRODUCTION
2. decrease uric acid EXCRETION
3. increase purine FOODS

Question 3

who is highest risk for developing gout?

Answer 3

-males, diuretics, immuno suppressants, high alcohol

Question 4

> ______ mg/dl = high level of uric acid leading to inflammation

Answer 4

> 7mg/dl

Question 5

Avoid which 2 drugs in particular if you have gout attacks

Answer 5

aspirin and diuretics

Question 6

risks with glucocorticoids

Answer 6

GI ulceration, fluid retention, hyperglycemia, decreased wound healing

long term = adrenal suppression

Question 7

drug that inhibits leukocyte infiltration–> prevents the destructive lysosomal enzymes

Answer 7

colchicine

Question 8

indication for using colchicine?

Answer 8

acute gout attack

Question 9

what is unique thing about the anti-inflammatory properties of colchicine?

Answer 9

only has anti-inflammatory properties for gout

Question 10

side effects and rare/serious side effects of colchicine

Answer 10

Regular SE: Gastrointestinal (25%) –> D/C drug if occurs

Rare/Serious SE: BM suppression, rhabdomyolysis, severe kidney or liver disease.

Question 11

how do we dose colchicine?

Answer 11

1.2 mg loading then 0.6 mg I hr later. Max 1.8/24 hrs

Question 12

Drug drug interactions for colchicine?

Answer 12

PGP or CYP3A4 drugs (cyclosporine, ketoconazole, clarithromycin, HIV protease )
-NO Grapefruit juice.

Question 13

which gout drug interacts with grapefruit ?

Answer 13

colchicine

Question 14

3 ways to prevent gout

Answer 14

Inhibit uric acid formation
Increase uric acid excretion
convert uric acid

Question 15

prevent gout

Answer 15

allopurinol (Zyloprim)

Question 16

how does allopurinol prevent gout?

Answer 16

reduces uric acid levels

• -Decreases tophi already formed
• -Decreases risk of urate crystals in the kidney

Question 17

drug that may cause an acute gout attack when first start taking it? what we gonna do about it?

Answer 17

allopurinol (Zyloprim)

also take something for acute gout attack like NSAIDS and Colchicine

Question 18

side effects/ rare side effects of allopurinol (Zyloprim)

Answer 18

Side Effects: common GI

Rare & Serious Side Effects: hypersensitivity syndrome

Question 19

which gout med interacts w/ warfarin?

Answer 19

allopurinol (Zyloprim)

Question 20

Need < ____ mg/dl of uric acid to get rid of tophi

Answer 20

<5 mg/dL