Gout Drugs

Question 1

Colchicine

Answer 1

Class: N/A

Mech: Prevents tubulin polymerization and leads to inhibition of leukocyte migration, phag, and release of cytokines.

Thera: Acute gouty arthritis

Tox: Nausea, vomiting, abd pain, diarrhea.
Long term use can cause peripheral neuropathy and neutropenia.

Misc: Works in 12-24 hours

Question 2

Probenecid

Answer 2

Class: Urinosuric Agent

Mech: Compete with urate at the anionic transport site of the renal tubule and inhibit urate reabsorption.

Thera: Chronic tophaceous gout

Tox: Urate crystal mobilization and acute gouty arthritis.
GI irritation.

Misc: Secretion of some weak acids (penicillin) is reduced.

Question 3

Allopurinol

Answer 3

Class: N/A

Mech: Reduces uric acid synthesis by inhibiting (competitively) xanthine oxidase.
Also produces alloxanthine which is a noncompetitive inhibitor of xanthine oxidase itself.

Thera: Chronic tophaceous gout

Tox: Acute attacks of gouty arthritis early in treatment due to mobilization of urate crystals.

Question 4

Febuxostat

Answer 4

Class: N/A

Mech: Non-purine, non-competitive antagonist of xanthine oxidase.

Thera: Chronic tophaceous gout

Tox: Nausea, rash, arthralgias

Misc: Expensive

Question 5

Pegloticase

Answer 5

Class: Recombinant stabilized uricase

Mech: Converts uric acid to allantoin.

Thera: Chronic tophaceous gout

Tox: N/A