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PHARMACOLOGY II > Gout > Flashcards

Gout Flashcards

1
Q

Metabolic disease that is characterized by recurrent episodes of acute arthritis due to deposits of monosodium urate in joints and cartilages

A

Gout

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2
Q

T or F: Gout is a disease characterized by recurrent chronic arthritis

A

False, acute

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3
Q

Gout is a systemic disease caused by the buildup of ____ in the ____ causing inflammation, swelling, and pain

A

uric acid, joints

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4
Q

Hyperuricemia levels in men and women

A

Men = >8 mg/dL
Women = 7 mg/dL

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5
Q

Most common first symptom of gout

A

Pain in joints of lower extremities

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6
Q

Type of gout which is a result of an innate defect in purine metabolism of uric acid excretion
- uric acid overproduction
- impaired renal clearance of uric acid
- combination

A

Primary Gout

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7
Q

Type of gout which is characterized by hematologic disorders

A

Secondary Gout

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8
Q

Treatment goals for Gout

A
  1. Relieve pain and inflammation
  2. Reduce serum uric acid concentration
  3. Prevent recurrent gout attacks
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9
Q

Alkaloid isolated from colchicum autumnale

A

Colchicine

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10
Q

Antimitotic drug effective in relieving acute gout attack

A

Colchicine

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11
Q

When is Colchicine most effective?

A

When initiated within 12-36 hours of the attack

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12
Q

T or F: Colchicine has a high benefit-to-risk ratio

A

False, low –> that’s why it used less often than NSAIDs

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13
Q

Can Colchicine be taken with or without food?

A

Yes

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14
Q

Colchicine duration of action

A

12-24 hours without altering urate metabolism

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15
Q

Mainstay therapy for acute gouty attacks

A

NSAIDs

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16
Q

Most common adverse effects of NSAIDs are related where?

A

GI system (gastritis, bleeding, perforation)

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17
Q

Most extensively studied NSAIDs for the treatment of acute gouty attacks

A

Indomethacin

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18
Q

MOA of NSAIDs

A
  1. inhibits PG synthesis
  2. inhibits urate crystal phagocytosis
  3. reduces inflammation and pain in acute gout flare
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19
Q

T or F: All NSAIDs effective for treating acute gouty arthritis attacks

A

False, exceptions include aspirin, salicylates, tolmetin

20
Q

T or F: Oxaprozin lowers serum uric acid

A

True

21
Q

Equivalent to NSAIDs in the treatment of acute gout flares

A

Corticosteroids

22
Q

Corticosteroids are effective when given into what routes?

A

Intra-articular, IV, oral

23
Q

Route of Prednisone

A

Oral

24
Q

Route of Triamcinolone acetonide or Methylprednisone

A

Intra-articular or IM

25
Q

Decreases activation, proliferation, survival of various inflammatory cells as well as decrease mitigation of neutrophils, inhibits prostaglandins, and proinflammatory cytokines (IL-1B)

A

Corticosteroids

26
Q

Indication of Corticosteroids

A

Alternative for patients contraindicated to NSAIDs or Colchicine as well as those with renal impairment or CKD

27
Q

T or F: Corticosteroids can sometimes be used for severe symptomatic gout

A

True

28
Q

What is the goal urate levels of Uric Acid Lowering Therapy?

A

< 6 mg/dL, preferably < 5 mg/dL

29
Q

Reduction of serum urate concentration can be done by?

A
  1. Decreasing uric acid synthesis - xanthine oxidase inhibitors
  2. Increasing renal excretion of uric acid - uricosurics
30
Q

Can xanthine oxidase inhibitors and uricosurics be used during acute gouty arthritis attacks?

A

No

31
Q

Reduces uric acids by impairing conversion of hypoxanthine to xanthine and ultimately xanthine to uric acid

A

Xanthine oxidase inhibitors

32
Q

T or F: XO inhibitors are effective for overproducers of uric acids only

A

False, effective for both over- and underproducers

33
Q

Most widely prescribed agents for long-term prevention of recurrent gout attacks

A

XO inhibitors

34
Q

Purine analog that inhibits xanthine oxidase resulting in a decreased level of plasma urate level

A

Allopurinol

35
Q

What is the result of XO inhibition?

A

Build up of its substrates = more soluble xanthine and hypoxanthine

36
Q

T or F: Allopurinol is the first-line agent for the treatment of acute gout attacks

A

False, chronic gout attacks

37
Q

Potent selective non-purine XO inhibitor, reducing xanthine and uric acid levels without affecting other enzymes in purine or pyrimidine pathway

A

Febuxostat

38
Q

Example of Uricosuric Drugs

A

Probenecid

39
Q

Uricosuric drugs that have been discontinued in the USA

A

Sulfinpyrazone and Lesinurad

40
Q

MOA of Uricosuric drugs

A

Increases renal excretion of uric acid through inhibition of post-secretory renal proximal tubular reabsorption of uric acid

41
Q

T or F: Probenecid can be given as monotherapy or in combination with XO inhibitors

A

True

42
Q

Interleukin-1 inhibitors

A

Canakinumab
Anakinra
Rilonacept

43
Q

MOA of IL-1 inhibitors

A

inhibits IL-1 receptors

44
Q

Main proinflammatory cytokines responsible for crystal-induced inflammation of gout

A

IL-1B

45
Q

Are Interleukin-1 inhibitors already FDA approved?

A

Not yet

46
Q

Route of administration for Interleukin-1 inhibitors

A

SubQ

PHARMACOLOGY II (4 decks)

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