Gout

Question 0

Nonselective irreversible COX 1&2 inhibitors
Prevention of arterial thrombosis
Inflammatory disorders
Prevents uric acid excretion

Answer 0

Aspirin

Question 1

Anti inflammatory drugs

Answer 1

NSAIDs

DMARDs

Question 2

Aspirin
<300
300-2400
2400-4000

Answer 2

Platelet aggregation first order
Antipyretic and analgesic
Anti inflammatory zero order

Question 3

Aspirin overdose

Answer 3

TD 150 mg/kg
LD 30g

HAGMA
Alkalinize with BICARBONATE

Question 4

Nonselective NSAID

Long term use reduces risk of colon cancer

Answer 4

Ibuprofen

Question 5

Nonselective NSAID
Post surgical anasthesia control
Only IV NSAID
WOF GI and nephrotoxicity

Answer 5

Ketorolac

Question 6

Nonselective NSAID
Closure of PDA
WOF APLASTIC ANEMIA THROMBOCYTOPENIA

Answer 6

Indomethacin

Question 7

Nonselective NSAID

COX2>1

Answer 7

Meloxicam

Peroxicam

Question 8

COX2 NSAID

Reduced risk for GI bleeding

Answer 8

Celecoxib

Question 9

COX2 NSAID

Inc risk for MI and stroke

Answer 9

Rofecoxib

Valdecoxib

Question 10

COX 3 Inhibitor
Preferred antipyretic for children
Inc hepatoxicity with alcohol

Answer 10

Paracetamol

Question 11

Paracetamol overdose
0.5-24 h
24-72 h
72-96 h
4d-2w

Answer 11

N/V
Elevated liver enzymes
Hepatic encephalopathy HAGMA
Recovery

NAC

Question 12

Most common form of chronic inflammatory arthritis

Answer 12

RA

Question 13

Inhibits AICAR transformylase and thymidilate synthase
Sec effects on PMN chemotaxis
WOF PSEUDOLYMPHOMATOUS REACTION and mucosal ulcers
FIRST CHOICE DMARD TO TREAT RA

Answer 13

Methotrexate

- rescue leucovorin

Question 14

Binds to TNFa to prevent TNFa receptor activation
WOF HEP B and TB REACTIVATION
WOF LYMPHOMA
Autoantibody formation
DMARD

Answer 14

Infliximab

Synergistic with methotrexate

Question 15

Forms 6 thioguanine
WOF BM SUPPRESSION AND LYMPHOMA
Do not give with Allopurinol
DMARD

Answer 15

Azathioprine

Question 16

Suppression of T lymphocyte response to mitogens, dec WBC chemotaxis, stabilize lysosomal enzymes, inhibit DNA and RNA synthesis, trap free radicals
WOF OCULAR TOXICITY
SAFE FOR PREGNANT
Malaria
DMARD

Answer 16

Chloroquine

Question 17

Forms phosphoramide mustard to prevent DNA replication
WOF HEMORRHAGIC CYSTITIS
DMARD

Answer 17

Cyclophosphamide

- rescue mesna

Question 18

Inhibits IL1 and IL2 receptor production
Sec inhibits macrophage T cell interaction and T cell responsiveness
Tissue transplantation
WOF nephrotoxicity gingival hyperplasia hirsutism
DMARD

Answer 18

Cyclosporine

Question 19

Active product (mycophenolic acid) inhibits IMP dehydrogenase and inhibits T cell lymphocyte proloferation
WOF REVERSIBLE MYELOSUPPRESSION (neutropenia)
DMARD

Answer 19

Mycophenolate Mofetil

Question 20

Active metabolite (sulfapyridine) inhibits release of inflammatory cytokines
Inflammatory Bowel Disease
WOF HA METHEMOGLOBINEMIA REVERSIBLE MALE INFERTILITY
DMARD

Answer 20

Sulfasalazine

Question 21

Inhibits microtubule assembly
FAMILIAL MEDITERRANEAN FEVER
INITIAL TREATMENT FOR ACUTE GOUT

Answer 21

Colchicine

Question 22

Alternative to colchicine in acute gout

Answer 22

Indomethacin

Question 23

Compete with uric acid for tubular reabsorption
WOF GI irritation and aplastic anemia
Prevent precipitation of scute gout during early phase of drug action by combination with colchicine or indomethacin

Answer 23

Probenecid

Question 24

Active metabolite alloxanthine rreversibly inhibits xanthine oxidase
FIRST LINE FOR CHRONIC GOUT
Tumor lysis syndrome
WOF cataracts
Inhibits metabolism of mercaptopurine and azathrioprine

Answer 24

Allopurinol

Question 25

Nonpurine reversible inhibitor of xanthine oxidase

More selective than allopurinol

Answer 25

Febuxostat