Gout Drugs Flashcards
Probenecid
MOA: Inhibits reabsorption of uric acid in proximal
convoluted tubule (also inhibits secretion of
penicillin). Can precipitate uric acid calculi.
Clinical use: chronic gout (preventative)
Adverse effects:
Allopurinol
MOA: Competitive inhibitor of xanthine oxidase
–> ↓ conversion of hypoxanthine and xanthine
to urate. Also used in lymphoma and leukemia
to prevent tumor lysis–associated urate
nephropathy. ↑ concentrations of xanthine
oxidase active metabolites, azathioprine, and
6-MP.
Clinical use: chronic gout (preventative)
Adverse effects:
Pegloticase
MOA: Recombinant uricase catalyzing uric acid to
allantoin (a more water-soluble product).
Clinical use: chronic gout (preventative)
Adverse effects:
Febuxostat
MOA: Inhibits xanthine oxidase.
Clinical use: chronic gout (preventative)
Adverse effects:
NSAIDs
Clinical use: acute gout
Any NSAID. Use salicylates with caution (may
decrease uric acid excretion, particularly at
low doses).
Glucocorticoids
Oral, intra-articular, or parenteral.
Clinical use: acute gout
Colchicine
MOA: Binds and stabilizes tubulin to inhibit
microtubule polymerization, impairing
neutrophil chemotaxis and degranulation.
Clinical use: acute gout; Acute and prophylactic value
Adverse effects: GI,
neuromyopathic side effects.