Gout

Question 1

Colchicine (Colcrys)

Answer 1

Mechanism: Prevents tubulin polymerization & leads to inibition of leukocyte migration, phagocytosis, and release of cytokines
Therapeutics: Acute gouty arthritis
Side Effects: Long-term use causes peripheral neuropathy & neutropenia

Question 2

Probenecid (Benemid)

Answer 2

Class: Uricosuric Agent
Mechanism: Compete with urate at the anionic transport site of the renal tubule and inhibit urate reabsorption
Therapeutics: Chronic tophaceous gout
Side Effects: Urate crystal mobilization and acute gouty arthritis

Question 3

Allopurinol (Zyloprim)

Answer 3

Mechanism: 1. Reduces uric acid synthesis by inhibiting xanthine oxidase (competitive inhibition) –> alloxanthine
2. Alloxanthine is a non-competitive inhibitor of xanthine oxidase
Therapeutics: Chronic tophaceous gout
Side Effects: Acute attacks of gouty arthritis early in treatment due to mobilization of urate crystals

Question 4

Febuxostat (Uloric)

Answer 4

Mechanism: Non-purine, non-competitive antagonist of xanthine oxidase
Therapeutics: Chronic tophaceous gout
Side Effects: Nausea, rash, arthralgias

Question 5

Pegloticase (Krystexxa)

Answer 5

Class: Recombinant, stabilized uricase
Mechanism: Converts uric acid to allantoin
Therapeutics: Chronic tophaceous gout