gout Flashcards
uric acid is a derivative from
purine
normal UA
2-7.2
tophi
crystallized UA in joint
painful gout attack with burning and swelling
Big toe
RF for UA
male
obesity
alcohol
drugs that increase uric acid
aspirin low dose
calcinurin inhibitors- tacrolimus and cyclosporine
diuretics
niacin
chemotherapy
some pancreatic enzymes
what diet restrictions for gout
organ meat, high fructose alcohol
healthy diet include- low fat dairy, veges weight control smoke cessation exercise hydration
tx once symptomatic
NSAIDS, steroids colchicine
preventative- xanthaneoxidaes inhibitor- allopurinol/febuxistat
if Ua is still>6 add probenecid or lesinurad replace XOI with IV pegloticase
colchicine
colcrys
2X0.6mg then 0.6mg
do not exceed 1.8mg in 1 hr
can cause myelosupression and myopathy risk
AE- diarrhea nausea neuropathy myopathy
start within 36 hours from onset
prophylaxis- 0.6mg once or twice daily
NSAIDS
indomethacin
naproxen
celecoxib
sulindac
steroids
prednisone/prednisolone
methylprednisolone - intraarticular
triamcinolone
xanthane oxidase inhibitor
MOA- decrease uric acid production
allopurinol- rash,
febuxistat- hepatoxic, skin reaction
uricosurics
moa- inhibit reabsorption of uric acid and increases excretion
lesinurad zurampic (add on to XOI)
probenecid can increase beta lactam levels
recombinant uricase
Krystexxa IV
premedicate with antihistamine and steroids
cannot us in G6PD defeciency
DO NOT USE IN COMBINATION WITH ALLOPURINOL/febuxistat or probbenecid
Tumour lysis syndrome
complication of chemo
cell death causing purine release
tx- rasburicase contraindicated with G6PD defeciency
D/C if hemolysis
HLB5801 test for
and what AE
allopurinol
severe rash TENSJS
heptoxic
