GOUT

Question 1

Which drugs can cause/exacerbate GOUT ? ( hyperuricaemia )

Answer 1

diuretics ( loop/thiazides)
ciclosporin, tacrolimus
cytotoxics
cancer

Question 2

What is a 1st line treatment in acute gout attack ?

Answer 2

NSAIDs ( diclofenac or naproxen)

Alternative: Colchicine

Question 3

What is 1st line treatment in gout prevention ( prophylaxis ) ?

Answer 3

Allopurinol

second line: feboxustat ( serious hypersensitivity reactions; anaphylaxis, SJS )

Question 4

What are uricosuric drugs ?

Answer 4

sulfinapyrazone ( side effects are; makes urine alkaline, allows urea crystals to from)
Ensure adequate renal function and urine output

Question 5

What is allopurinol ?

Answer 5

xanthine oxidase inhibitor

Question 6

Wha are the side effects of allopurinol ?

Answer 6

rashes ( if mild re-introduce slowly, stop if occurs again)

Question 7

How should allopurinol be taken ?

Answer 7

with or after food

Question 8

if mercaptopurine or azathioprine given with allopurinol, what is the concern ?

Answer 8

allopurinol inhibits these two drugs, thus can cause toxicity, therefore the dose of these two drugs must be reduced by 25-50%