Gout

Question 1

Colchicine (Acute Attack)

Answer 1

• Disrupts microtubulesàdecr neutrophil migration into joint
• Specific for gout & gout prophylaxis (lower dose)
• AEs: diarrhea, nausea, vomiting, abdominal pain

Question 2

Prednisone & Indomethacin (Acute Attack)

Answer 2

• Block inflammation
• Gout & gout prophylaxis
• Avoid ASA (competes with urate secretion by kidney & will raise serum urate levels)
• See other cards

Question 3

Probenecid (Prophylaxis, Blocks Reabsorb)

Answer 3

• Uricosuric [prototype]
• Inhibit reabsoprtion of uric acid in kidney
• Gout prophyaxis
• AEs: rash, uric acid stones (alkanalize urine w/bicarbonate) Don’t use with ASA
• AKA Benemid

Question 4

Sulfinpyrazone (Prophylaxis, Blocks Reabsorb)

Answer 4

• Prototype: probenecid
• AEs: GI complaints (rash not listed)
• AKA Anturane

Question 5

Allopurinol (Prophylaxis, Block formation)

Answer 5

• Xanthine oxidase inhibitor [prototype]
• Suicide substrate; decr uric acid synthesis
• Gout prophylaxis
• AEs: severe drug interaction w/ 6-mercaptopurine/azathioprine
• AKA Zyloprim

Question 6

Febuxostat (Prophylaxis, Blocks formation)

Answer 6

• Xanthine oxidase inhibitor [prototype]
• Non-purine inhibitor
• Hyperuricemia, gout
• PO; Better tolerated than allopurinol
• AKA Uloric

Question 7

Rasburicase (Not for Gout, for Metabolizing Urate)

Answer 7

• Urate oxidase [prototype]
• Recombinant urate oxidase enzyme from Aspergillus rapidly converts urate into allantoin (more soluble)
• Tumor lysis, prevents renal failure, reduces need for transfusions in patients with tumor lysis syndrome NOT used for gout
• AEs: can only use it once bc develop Ab
• AKA Elitek