Gout Flashcards
Uricosuric drugs
Probenecid
Sulfinpyrazone
Lesinurad
Uricosuric drugs - Clinical use
Prevent gout attacks in persons who under-excrete uric acid.
Probenecid - MoA
Increases excretion of uric acid by competitive inhibition of uric acid reabsorption
Probenecid - Interactions
Aspirin and salicylates: interfere with the uricosuric effect.
High dose of salicylates: inh uric acid reabsorption
Low doses of salicylates: inh uric acid secretion
Sulfinpyrazone - MoA
Complete inhibition of urate reabsorption, increasing uric acid excretion
Sulfinpyrazone - Adverse
GI, renal and hematologic adverse effects
Lesinurad - MoA
Reduces uric acid levels by inh the function of transporters responsible for uric acid reabsorption, uric acid transporter 1 and organic anion transporter 4.
Xanthine oxidase inhibitors
Allopurinol
Febuxostat
Xanthine oxidase inhibitors - MoA
Decreases production of uric acid
Xanthine oxidase inhibitors - Clinical use
Prevent gout attacks in people who overproduce uric acid.
Prevent hyperuricemia and gout in persons having cancer chemotherapy and whose rate of purine catabolism is high.
Allopurinol - MoA
Competitive inhibitor of xanthine oxidase
Converted to active metabolite oxypurinol in the liver
Decrease in uric acid excretion and corresponding increase in urinary excretion of hypoxanthine.
Allopurinol - Clincal use
Hyperuricemia and gout in cancer patients with high purine catabolism
Prevent the occurrence or progression or both gouty arthritis and urate nephropathy
Tumor lysis syndrome
Lesch-Nyhan syndrome
Allopurinol - Adverse
Nausea, vomiting, hepatitis, skin rashes, hypersensitivity.
Steven-Johnson syndrome
Eosinophilia
DRESS syndrome
Allopurinol - Interactions
Inhibits catabolism of azathioprine and mercaptopurine
Febuxostat - MoA
Competitive inhibitor of xanthine oxidase
Febuxostat - Adverse
Liver enzyme elevations, nausea, arthralgia, rash
Catabolic enzyme preparations
Pegloticase and Rasburicase
Catabolic enzyme preparations - MoA
Reverse hyperuricemia
Pegloticase - Clinical use
Refractory chronic gout
Pegloticase - Adverse
Life-threatening allergic reactions
Hemolysis in G6PD deficiency
Rasburicase - Clinical use
ONLY: initial management of plasma uric acid in pediatric and adults with leukemia, lymphoma and solid tumor malignancies who are receiving anticancer therapy
Rasburicase - Adverse
Allergic reactions
Drugs for treating gout attacks
Indomethacin
Clochicine
Prednisone
Indomethacin - MoA
Anti-inflammatory drug for rapid relief of pain
Clochicine - MoA
Disrupting microtubules and inh of inflammatory leukocyte motility –> blocking their ability to cause urate crystal-induced joint inflammation
Clochicine - Adverse
Nausea, vomiting, diarrhea, abdominal cramps
Indomethacin, Clochicine, Prednisone - Clinical use
Acute gout
