Gout Flashcards
Gout is a disorder of ________ causing _______ to crystallize in joints and tendons.
Gout is a disorder of purine metabolism causing uric acid to crystallize in joints and tendons.
What are the deposits of monosodium urate crystals called and where are they commonly found?
Tophi
Fingers, ear
What are the uric acid promoting drugs?
Aspirin
Diuretics: thiazide, loop
What dietary habits are gout associated with?
Alcohol
Fructose-sweetened drinks
Meat
Seafood
What drugs are used to treat acute gout attacks?
NSAIDs
Steroids
Colchicine
What drugs are used for prophylactic treatment?
Colchicine
Allopurinol
Probenecid
What is the first line treatment for gout?
NSAIDs
Tx for 1-2 weeks
Indomethacin
Cat:
Ind:
MOA:
Indomethacin
Cat: NSAID
Ind: Gout, arthritis, bursitis, migraine
MOA: COX-1 (affects mostly the mucosa in stomach) and COX-II inhibition
Indomethacin/Indocin
SE
Bleeding, gastritis, PUD, exacerbate HTN or CHF
Indomethacin/Indocin CI
Caution: preexisting renal/liver disease, pts with hx of asthma and nasal or sinus polyps
CI: Hx of allergy to NSAID,
What is Samter’s triad?
Asthma, Aspirin and NSAID sensitivity and nasal/ethmoidal polyposis
Cortisone injection
Cat:
Ind:
MOA:
Cortisone injection
Cat: Steroid
Ind: Short term pain relief, reduce swelling from inflammation
MOA: decreases inflammation by inhibiting pro-inflammatory proteins
Cortisone SE
Hyperglycemia, insulin resistance, DM, Osteoporosis, anxiety, depression, amenorrhea, cataracts and glaucoma
Colchicine
Cat:
Ind:
MOA:
Colchicine
Cat: Mitotic inhibitor
Ind: Gout (acute and prophylaxis)
Colchicine
MOA
MOA: INHIBITS MICROTUBULE POLYMERIZATION BY BINDING TO TUBULIN (inhibits mitosis) also inhibits neutrophil motility and activity = antiinflammatory
Colchicine
SE
PERIPHERAL NEUROPATHY GI upset anemia neutropenia hair loss
Overdose: vomiting, diarrhea, acute renal failure, hypovolemic shock
Allopurinol/Zyloprim
Cat:
Ind:
MOA:
Allopurinol/Zyloprim
Cat: Purine analog
Ind: Hyperuricemia, gout, prophylaxis against tumor lysis syndrome
MOA: Xanthine oxidase inhibitor
Allopurinol/Zyloprim
SE:
N/V Rash SJS (Stevens-Johnson Syndrome) Hepatitis Decreased renal function
What are uricosurics?
Substances that increase the excretion of uric acid in the urine, reducing the concentration of uric acid in the plasma.
Probenecid/Probalan
Cat:
Ind:
Probenecid/Probalan
Cat: Uricosuric
Ind: Hyperuricemia, gout
Probenecid/Probalan MOA
Interfers with OAT (organic anion transporter) which reclaims uric acid from the urine and returns it to the plasma = increased urinary excretion of uric acid
Probenecid/Probalan SE
GI upset, gastritis, N/V, anemia, leukopenia, hemolytic anemia (pts with G6PD def)
EXACERBATION OF GOUT FOLLOWING THERAPY
MAY CAUSE FORMATION OF URIC ACID RENAL STONES
