Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Therapeutics IV Final Subjects > Gout > Flashcards

Gout Flashcards

1
Q

What is the normal value of uric acid?

A

3-7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the goal for a gout pt?

A

6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Do human have enzyme to break down uric acid?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Gout affects men and women equally. T or F

A

False, it affects men more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Gout is a common form of inflammatory ______ in adults.

A

arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Does prevalence of gout inc with age?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When do men and women separate in terms of how many of the respective populations have high uric acid?

A

in the 10-14 y.o. range

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

High serum uric acid levels above ___ will parcipitate out in the _____ more because of the lower pH

A

6.8, joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

After crystals start to form in the joint two things start to happen, what are they?

A

activation of the innate immune system via IL-1 production resulting in acute gout arthritis flares AND continued deposition of urate cyrstals leading to formation of tophi and bone erosion both of these lead to symptoms of gouty arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the most common sxs of gouty arthritis?

A

warm sensation, redness, pain, swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

does acute gouty arthritis usually affect more than one joint?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

does serum uric acid levels confirm or exclude gout?

A

nope; you can have hyperuricemia and not have gout or you can and gout but have normal uric levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some other conditions that should be ruled out before you assume its gout?

A

pseudogout, septic arthritis, cellulitis, arthritis (RA, OA, PA), lyme disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a strong risk factor for gout?

A

higher adiposity and wt gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Is weight loss protective for gout?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are 5 comorbidities associated with gout?

A

HTN, obesity, hyperlididemia, CKD, CVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does lipid lowering agents do to gout?

A

inc serum uric acid over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What anti-HTN meds are assocaited with inc uric acid and gout?

A

Diuretics, beta blockers, ACE, Non-losartan ARBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What anti-HTN meds dec uric acid?

A

CCB and losartan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Does alcohol intake inc risk of gout?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which type of alcohol inc risk of gout the most and least?

A

Beer is most, wine is least

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

if someone is going to take alcohol can you inc the dose of allopurinol?

A

yes, only real toxicity is hypersensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What drugs lead to inc uric acid reabsorption?

A

diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what drug inc serum urate and dec uric acid clearance?

A

low-dose apsirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what three drugs have higher incidence of gout?

A

pyrazinamide, ethambutol, niacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is Tophaceous gout?

A

deposits of uric acid crystals that occur in cartilage (ears, joints, epiphyseal joints, tendon, bursa, heart, etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What can cause the Tophi?

A

long duration of gyperuricemia, high uric acid levels, untreated gout (11 yrs or under-tx), or have more than 4 or more attacks per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Is tophaceous gout treatable with drugs? which ones?

A

Yes: probenecid, allopurino, febuxostat, pegloticase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the two types of classifications of gout?

A

metabolic and renal (90%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is characteristic of metabolic gout?

A

overproducers from either molectular defects, enzymatic defects, onset at young age, high incidence of uric acid stones or high turn over in nucleic acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what are the three reasons for renal gout?

A

reduced filtration, enhanced reabsorption, decreased secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are drugs that cause renal gout?

A

diuretics, ASA, pyrazinaminde, niacin, ethambutol, ethanol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Can starvation ketosis, diabetic ketoacidosis, and lactic acidosis cause renal gout?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the normal uric acid levels for males and females?

A

M: 3-7

F 3-6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

tx in serum lvl even tho they dont have gouty arthritis?

A

yes

36
Q

Which one of the following drugs is not effective in tx acute gout attacks?

A

Acetaminophen (no inflammatory properties)

37
Q

What are some tx for acute gout therapy?

A

indomethacin (indocin), Naproxen (Naprosyn), Sulindac (Clinoril), Colchicine (colcrys), interlukin 1b inhibitors (Canakinuma, Rilonacept, anakinra)

38
Q

what are the goals of gout therapy?

A

terminate acute attack rapidly, prevent future acute gouty attacks, lower uric acid levels to prevent deposits, prevent formation of uric acid calculi, tx accompanying disorders (obesity, excess alcohol ingestion, etc)

39
Q

Do not take more than 3 tablets of ________

A

colchincine

40
Q

can you get gi effects from colchicine?

A

yes

41
Q

What drug inc toxic effect of colchicine?

A

clarithromycin

42
Q

What do you do for colchicine if they are on weak 3A4 inhibitors?

A

just take 2 tablets (0.6mg each)

43
Q

What do you do for colchicine if they are on strong 3A4 inhibitors?

A

just take 1 tablet (0.6mg) then half a tablet (0.3mg) an hour later if needed

44
Q

How fast does indomethacin for for acute gout attacks? Do you need high or low doses of indomethacin? What population do you have to be care with NSAIDs?

A

2-4hrs; high; elderly from bleeding risk

45
Q

What are some corticosteropids for acute gout attacks?

A

methylprednisolone (5-10mg for small joints) (20-60mg for large joints)

Prednison 30-50 mg daily tapering in a 7-10 day period

ACTH or triamcinolone acetonide

46
Q

prophylaxis for acute gout is what?

A

Colchicine 0.6 mg one to two times daily (NSAIDs may be added)

47
Q

What are the three TYPES of urate-lowering strategies?

A

Uricosuric agents, uricostatic agents and uricolytic agents

48
Q

What drug is a uricosuric agent?

A

Probenecid

49
Q

What drug is a uriostatic agent?

A

allopurinol, febuxostat

50
Q

What drug is a uricolytic agent?

A

pegloticase

51
Q

When would you not use Probenecid?

A

when you have poor renal function of CrCl <30 because its not going to push out the uric acid

52
Q

Can Uric Lowering therapy (ULT) cause an acute gout flare-up? All of them? What do you do to prevent it?

A

Yes; Yes; give flare prophylaxis like colchicine

53
Q

What is the starting dose of allopurinol?

A

100mg/day

54
Q

inc by how much of allopurinol per week?

A

100mg/day

55
Q

what is the average daily dose of allopurinol?

A

300mg/day

56
Q

What is the max daily dose of allopurinol?

A

600mg/day

57
Q

What are some indications for allopurinol?

A

overproducers, secretions greater than 1000mg/day, pts with renal failure, hx or renal calculi, Tophaceous gout, allergies to uricosurics, prior to using cytotoxic agents

58
Q

What is the brand name of Uloric?

A

Febuxostat

59
Q

What is the MoA of uloric?

A

non-purine selective xanthine oxidase inhibitor

60
Q

What is the starting dose?

A

40mg/day

61
Q

How much do you inc Uloric dose?

A

40mg up to a total of 80mg/day if not at goal

62
Q

Is there another of side effects from febuxostat?

A

Nope, well tolerated

63
Q

Do you have to renal adjust or discontinue cuz its toxic or doesnt work in renal imparied?

A

No, no need to consider renal impairment

64
Q

What is the official approval for febuxostat?

A

chronic tx of hyperuricemia in pts with gout

65
Q

are there skin reactions with Uloric?

A

yes

66
Q

What is pegloticase and how does it work?

A

It is an enzyme that performs like uricase

67
Q

what is the dose of pegloticase?

A

8mg IV over 2 hrs q2wks

68
Q

How long does pegloticase take to work?

A

6 hours

69
Q

What are some side effects of pegloticase?

A

chest pain, chills, nausea and HA

70
Q

Is pegloticase recommeneded for asymptomatic hyperuricemia?

A

nO

71
Q

do pts develop antibodies?What does that do to tx?

A

yes, it dec efficacy

72
Q

What pts usually receive pegloticase?

A

cancer pts

73
Q

What is the brand name of Rasburicase?

A

Elitek

74
Q

What is the indication for Elitek?

A

management of plasma uric acid levles in pt with leukemia, lymphoma, and solid tumor malignancies who are receiving anticancer therapy resulting in tumor lysis syndrome and release of uric acid

75
Q

Whats the dose of rasburicase?

A

once daily for 5 days as a single course tx only.

76
Q

Is resburicase indicated for gout?

A

No

77
Q

What pt population is rasburicase used for?

A

cancer

78
Q

What 3 guidelines are effective for reducing frequency and/or severity of acute flares in patients iwth gout?

A

maintianing target UA <6mg/dl
the use of ULT continuously instead of intermittently
using colchicine for flare prophylaxis when initiation ULT and continuing past ULT initiation

79
Q

What drug shows evidence for acute flare up prophylaxis?

A

colchicine

80
Q

Does NSAIDs show benefit for acute flare ups or prophylaxis?

A

flare ups yes, prophylaxis no

81
Q

Will gout require life time therapy?

A

Yes

82
Q

How much water should gout pts drink?

A

2 liters or more

83
Q

what do you do if you have GI upset when taking

A

take with food

84
Q

What two things should you avoid because of acid risk?

A

aspirin and vit C

85
Q

Should you avoid purine rich foods?

A

Yes

Therapeutics IV Final Subjects (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions