Gout Flashcards
3 drugs for acute gout attack
NSAIDS
Glucocorticoids
Colchicine
Causes of Gout
- increase uric acid PRODUCTION
- decrease uric acid EXCRETION
- increase purine FOODS
who is highest risk for developing gout?
-males, diuretics, immuno suppressants, high alcohol
> ______ mg/dl = high level of uric acid leading to inflammation
> 7mg/dl
Avoid which 2 drugs in particular if you have gout attacks
aspirin and diuretics
risks with glucocorticoids
GI ulceration, fluid retention, hyperglycemia, decreased wound healing
long term = adrenal suppression
drug that inhibits leukocyte infiltration–> prevents the destructive lysosomal enzymes
colchicine
indication for using colchicine?
acute gout attack
what is unique thing about the anti-inflammatory properties of colchicine?
only has anti-inflammatory properties for gout
side effects and rare/serious side effects of colchicine
Regular SE: Gastrointestinal (25%) –> D/C drug if occurs
Rare/Serious SE: BM suppression, rhabdomyolysis, severe kidney or liver disease.
how do we dose colchicine?
1.2 mg loading then 0.6 mg I hr later. Max 1.8/24 hrs
Drug drug interactions for colchicine?
PGP or CYP3A4 drugs (cyclosporine, ketoconazole, clarithromycin, HIV protease )
-NO Grapefruit juice.
which gout drug interacts with grapefruit ?
colchicine
3 ways to prevent gout
Inhibit uric acid formation
Increase uric acid excretion
convert uric acid
prevent gout
allopurinol (Zyloprim)
how does allopurinol prevent gout?
reduces uric acid levels
- -Decreases tophi already formed
- -Decreases risk of urate crystals in the kidney
drug that may cause an acute gout attack when first start taking it? what we gonna do about it?
allopurinol (Zyloprim)
also take something for acute gout attack like NSAIDS and Colchicine
side effects/ rare side effects of allopurinol (Zyloprim)
Side Effects: common GI
Rare & Serious Side Effects: hypersensitivity syndrome
which gout med interacts w/ warfarin?
allopurinol (Zyloprim)
Need < ____ mg/dl of uric acid to get rid of tophi
<5 mg/dL
