Gout/hyperuricemia Pharmacotherapy Flashcards
Early duration of acute gouty arthritis is < __ hours after attack onset
12
Well established duration of acute gouty arthritis attack is __ to __ hours after attack onset
12, 36
Late duration acute gouty arthritis attack is > __ hours after attack onset
36
polyarticular acute gout arthritis?
4 or more joints involving more than 1 region; or involving 3 separate large joints
What score is mild gout?
<=4
What score is moderate gout?
5-6
What score is severe gout?
7-10
Goal serum urate of gout therapy?
< 6mg/dL
What is alcohol overuse in gout pts?
male: more than 2 servings/day
female: more than 1 serving/day
What meats should be avoided in gout pts?
organ meats
limit beef, lamb, port, seafood
3 drugs for acute gouty arthritis:
- nsaids
- colchicine
- corticosteroids
3 nsaids FDA approved for gout Tx?
- indomethacin
- naproxen
- sulindac
What is 2nd line for gout?
IL1 inhibitors
- at least 6 months
- 3 months after achieving serum urate goals
- 6 months after achieving serum urate goals
Inadequate Tx response is < __ % improvement in pain score within 24 hours
20
Inadequate Tx response is < ___ % if greater than 24 hours
50
colchicine has no analgesic property but can provide anti mitotic benefit up to __ hours after onset of attack
36
Established Dx of gouty arthritis and serum urate > __ mg/dL is indication for ULT
9
Established Dx of gouty arthritis and CKD stage __ or worse is indication for ULT
3
What drug class is first line Tx for gout?
xanthine oxidase inhibitors
What is alternative 2nd line agent if XOI is CI?
probenecid
How long should concomitant anti-inflammatory prophylaxis be continued with ULT therapy?
3-6 months
Which gout med should not be initiated during gout flare?
probenecid
How long is ULT therapy continued?
indefinitely
If pt is having gout flare and ULT needs to be started, should it be initiated during the flare?
yes
exception: probenecid - do not initiate probenecid during flare
