Gout

Question 1

What levels in Men and Women is considered Hyperuricema?

Answer 1

Hyperuricemia defined as:

Men: >7 mg/dL
Women: > 6 mg/dL

Question 2

What is the most likely cause of Hyperuricmea?

Under or Over production?

Answer 2

Overproduction

relative decrease in the renal excretion of uric acid for an unknown reason (primary idiopathic hyperuricemia)

Question 3

When is Colchacine used and most effective?

Answer 3

Acute attacks of gout-resolution of pain

If started within 36 hours of attack onset

Question 4

MOA of Colchicine?

Answer 4

Inhibition of microtubule assembly decreases macrophage migration and phagocytosis

Inhibits leukotriene B4 decreasing inflammation

Question 5

ADE of Colchicine?

Answer 5

GI adverse effects (diarrhea, nausea, vomiting)

Question 6

What dosing instructions are needed when taking Colchicine?

Answer 6

Terminating acute attack

1.2mg followed by 0.6mg in 1 hour

Question 7

When is urate lowering thearpy Xanthin Oxidase Inhibitors best used?

Answer 7

Efficacious for the prophylaxis of recurrent gout attacks in both underexcreters and overproducers of uric acid

Question 8

When using Urate Lowering therapy what must also be administered with them?

Answer 8

NSAIDS or corticosteroids

Question 9

What drugs are 1st line Urate Lowering Therapy?

Answer 9

Allopurinol and Febuxostat

Question 10

MOA of Allopurinol?

When is it best used?

Answer 10

Active metabolite irreversibly inhibits xanthine oxidase and lowers production of uric acid

Chronic Gout

Question 11

What is an Toxicity effect of taking Allopurinol?

Who needs genetic testing to avoid this toxicity?

Answer 11

Acute Hypersensitivity Syndrome

Koreans with CKD
Han Chinese and Thai irrespective of renal function

Question 12

MOA of Febuxostat

Answer 12

Reversible inhibitor of xanthine oxidase