Gout/hyperuricemia Pharmacotherapy

Question 1

Early duration of acute gouty arthritis is < __ hours after attack onset

Answer 1

12

Question 2

Well established duration of acute gouty arthritis attack is __ to __ hours after attack onset

Answer 2

12, 36

Question 3

Late duration acute gouty arthritis attack is > __ hours after attack onset

Answer 3

36

Question 4

polyarticular acute gout arthritis?

Answer 4

4 or more joints involving more than 1 region; or involving 3 separate large joints

Question 5

What score is mild gout?

Answer 5

<=4

Question 6

What score is moderate gout?

Answer 6

5-6

Question 7

What score is severe gout?

Answer 7

7-10

Question 8

Goal serum urate of gout therapy?

Answer 8

< 6mg/dL

Question 9

What is alcohol overuse in gout pts?

Answer 9

male: more than 2 servings/day
female: more than 1 serving/day

Question 10

What meats should be avoided in gout pts?

Answer 10

organ meats

limit beef, lamb, port, seafood

Question 11

3 drugs for acute gouty arthritis:

Answer 11

• nsaids
• colchicine
• corticosteroids

Question 12

3 nsaids FDA approved for gout Tx?

Answer 12

• indomethacin
• naproxen
• sulindac

Question 13

What is 2nd line for gout?

Answer 13

IL1 inhibitors

• at least 6 months
• 3 months after achieving serum urate goals
• 6 months after achieving serum urate goals

Question 14

Inadequate Tx response is < __ % improvement in pain score within 24 hours

Answer 14

20

Question 15

Inadequate Tx response is < ___ % if greater than 24 hours

Answer 15

50

Question 16

colchicine has no analgesic property but can provide anti mitotic benefit up to __ hours after onset of attack

Answer 16

36

Question 17

Established Dx of gouty arthritis and serum urate > __ mg/dL is indication for ULT

Answer 17

9

Question 18

Established Dx of gouty arthritis and CKD stage __ or worse is indication for ULT

Answer 18

3

Question 19

What drug class is first line Tx for gout?

Answer 19

xanthine oxidase inhibitors

Question 20

What is alternative 2nd line agent if XOI is CI?

Answer 20

probenecid

Question 21

How long should concomitant anti-inflammatory prophylaxis be continued with ULT therapy?

Answer 21

3-6 months

Question 22

Which gout med should not be initiated during gout flare?

Answer 22

probenecid

Question 23

How long is ULT therapy continued?

Answer 23

indefinitely

Question 24

If pt is having gout flare and ULT needs to be started, should it be initiated during the flare?

Answer 24

yes

exception: probenecid - do not initiate probenecid during flare