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Pharm Midterm 2 > Gout > Flashcards

Gout Flashcards

1
Q

Composition of Gout Crystals

A

Sodium Urate

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2
Q

What is tumor lysis syndrome

A

Massive tumor lysis
Release of nucleotides
Hyperuricemia
Renal injury

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3
Q

What is the DOC for gout pain

A

Indomethacin

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4
Q

What can be given to control pain in gout

A

Indomethacin
NSAIDs
Colchicine
Glucocorticoids

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5
Q

What can be given to treat gout (reduce serum urate)

A

Allopurinol
Probenecid
Sulfinpyrazone
Rasburicase

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6
Q

What suppresses leukocyte recruitment and activation

A

Indomethacin
NSAIDs
Colchicine
Glucocorticoids

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7
Q

Why are COX-2 inhibitor use limited

A

Increased CV risk

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8
Q

What are the AE for Indomethacin

A

Bleeding
Na, H2O retention
Renal Insufficiency

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9
Q

What do you never give for gout pain

A

Low dose Aspirin

Competes with urate for PT secretion

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10
Q

How does Colchicine work

A

Bind tubulin to inhibit MT production
Disrupts mitotic spindle
Inhibition of synth/release of LTs

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11
Q

Do we give Colchicine anymore

A

No…Then why the fuck are we learning this

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12
Q

Main Colchicine AE

A

Diarrhea

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13
Q

Other Colchicine AE

A

Pain
N/V
Myopathy, neutropenia, aplastic anemia, alopecia

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14
Q

When should Colchicine be given with caution

A

Hepatic, Renal, CV disease

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15
Q

What decreases uric acid synthesis

A

Allopurinol

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16
Q

How does Allopurinol work

A

Inhibits xanthine oxidase

Dissolutes tophi

17
Q

What is Allopurinol an analog of

A

Purine

18
Q

What is the initial effect of Allopurinol

A

Increase attacks

Mobilization of tissue stores of urate

19
Q

What do you co-administer Allopurinol with

A

NSAID

Colchicine

20
Q

What are the main AE of Allopurinol

A

HS

Skin rash –> S-J syndrome

21
Q

Allopurinol with rash next step

A

Stop the damn Allopurinol

22
Q

What prevents renal damage during cancer therapy

A

Allopurinol

Rasburicase

23
Q

Reduces doses of 6-MP and Azathioprine

A

Allopurinol

24
Q

How does Allopurinol decrease doses of 6-MP and Azathioprine

A

Xanthine oxidase metabolizes them normally

25
Q

What enhances urate excretion

A

Probenecid

Sulfinpyrazone

26
Q

How do Uricosuric agents work

A

Compete with urate for transporter blocking reabsorption

27
Q

What do you coadminister uricosuric agents with

A

NSAIDs

28
Q

Main AE of Sulfinpyrazone

A

Decrease hematopoesis

Inhibit Warfarin metabolism

29
Q

What are the Uricosuric agent AEs

A

GI irritation
HS
Renal stones

30
Q

When are Uricosuric agents contraindicated

A

Gout pt with nephrolithiasis/urate overproduction

Blood dyscrasia

31
Q

How does Rasburicase work

A

Oxidizes uric acid to allantoin

Easily excreted

32
Q

What is a recombinant Aspergillus uricase

A

Rasburicase

Pharm Midterm 2 (52 decks)

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