Gout

Question 1

1st line of tx for gout

Answer 1

indomethacin (NSAID)

Question 2

what is Colchicine used for? what is its process?

Answer 2

reducing pain and inflammation in acute gout attack

produce anti-inflammatory effect by inhibiting leukocytes migration and phogyctosis

Question 3

Side effect Colchicine

Answer 3

Diarrhea

Question 4

Xanthine oxidase inhibitors

Answer 4

Allopurinol and Febuxostat

Question 5

when is Allopurinol used?

Answer 5

agent for periods between acute gout attack

Question 6

when is Febuxostat

Answer 6

when people have allopurinol intolerance

Question 7

Uricosuric drugs: agents and function?

Answer 7

Probenecid or Sulfinpyrazone

increase renal clearance of uric acid

Question 8

what agents are used for acute gout?

Answer 8

NSAIDS: indomethacin

Colchicine

Question 9

Low dose Aspirin

Answer 9

analgesic, antipyretic effects: shorter 1/2 life, 1st order kinetics

Question 10

high dose Aspirin

Answer 10

Anti-inflammatory; longer 1/2 life, zero order kinetics

Question 11

Aspirin therapeutic effect

Answer 11

• acute rheumatic fever
• analgesia
• anti-inflammatory
• anti-pyretic
• anticoagulant effect

Question 12

Anti-inflammatory MOA

Answer 12

inhibition of COX2 & PG synthesis

Question 13

ANti- pyretic MOA

Answer 13

inhibition of PGE2(fever)–blocks production of prostaglandin to CNS to “reset” temp contorl in hypothalamus –>fall of temp due to dilation of superficial blood vessels

Question 14

Antithrombotic effects

Answer 14

irreversible inhibition of COX1–inhibit platelet formation

Question 15

Asprin rxn with:
Ethanol
Warfarin
Uricosurics

Answer 15

ethanol: increase GI bleeding
warfarin: increase effects
Uricosuric: decrease effects

Question 16

NSAIDS (Aspirin) adverse effects

Answer 16

GI upset: GI bleeding due to COX1

• prolong bleeding due to platelet inhibition
• decreased kidney fuction
• edema

Question 17

what are the COX2 selective inhibitors

Answer 17

Celecoxib, Etoricoxib, Meloxicam

Question 18

what can cause Hypersensitivity: pruritus

Answer 18

Aspirin (non-selecive NSAIDS)

Question 19

what can cause Reye’s syndrome

Answer 19

Aspirin(NSAIDS)

Question 20

COX 2 inhibitor therapeutic effects

Answer 20

analgesic, antipyretic, anti-inflammatory with LESS GI adverse effects

Question 21

which NSAID is approved for rheumatoid arthritis and osteoarthritis with black box warning

Answer 21

Celecoxib

Question 22

Which NSAID SE can cause cardiovascular thrombotic events?

Answer 22

COX2 inhibitors

Question 23

Acetaminophen therapeutic use/ pharmokinetics

Answer 23

inhibits COX1/2, pain reliever and fever reducer, NO anti-inflammatory properties

DO not inhibit platelet aggregation

Question 24

Acetaminophen Adverse effects

Answer 24

Hepatotoxicity–has narrow therapeutic window

Question 25

Non selective NSAID side effects

Answer 25

Gastric ulcers, anemia, GI hemorrhage, perforation/obstruction

Question 26

COX2 specific side effects

Answer 26

Cardio effects: MI, stroke, thrombosis

Question 27

what enzyme is the main inflammatory resposne

Answer 27

PGE2 and PGI2

Question 28

COX1 function

Answer 28

protective function, produce prostaglandin in stomach mucosa–protect stomach lining from gastric acid

• mediates platelets
• continuously active; ‘house keeping functions’

Question 29

COX2 function

Answer 29

inducible: requires event in order to be stimulated. Production of inflammatory molecules

Question 30

which COX mediates platelets

Answer 30

COX1