Gout medications

Question 1

What causes elevated uric acid

Answer 1

Making too much or not getting rid of it effectively

Question 2

What do urocusuric class medications do

Answer 2

increases urine secretion of uric acid

Question 3

What does an anti-urocusuric class of drug do

Answer 3

Withhold uric acid from the urine (aspirin, HCTZ, lasix)

Question 4

What treatment is used in an acute gouty attack

Answer 4

NSAIDs
Steroids
Colchicine

Question 5

What treatments can be used as gout attack prophylaxis

Answer 5

Colchicine
Allopurinol
Probenecid

Question 6

What drug class is Indomethacin

Answer 6

NSAID

Question 7

What are the indications of indomethacin

Answer 7

Gout, arthritis, bursitis, migraines, hemicrania, pain and swelling

Question 8

What is the MOA of cortisone injection

Answer 8

Inhibits pro-inflammatory proteins

Question 9

What are some side effects of intra-articular cortisone injections

Answer 9

pain, infection, skin pigment changes, loss of fatty tissue and tendon rupture. (Plus all the usual systemic side effects)

Question 10

What drug class is colchicine

Answer 10

Mitotic inhibitor

Question 11

What is the indication for using colchicine

Answer 11

Gout, acute and prophylaxis

Question 12

What is MOA of colchicine

Answer 12

inhibits polymerization by binding to tubulin, one of the main constituents of microtubles. Colchicine also inhibits neutrophil motility and neutrophil activity, resulting in an anti-inflammatory effect

Question 13

What are some side effects of colchicine

Answer 13

Marked GI upset, Peripheral neuropathy, hair loss, anemia, neutropenia

Question 14

What are colchicine OD symptoms

Answer 14

vomiting, diarrhea, acute renal failure and possible hypovolemic shock. put the patient on dialysis because there is no antidote

Question 15

What drug class is allopurinol (zyloprim)

Answer 15

purine analog

Question 16

What are the indications for allopurinol (zyloprim)

Answer 16

hyperuricemia, gout, prophylaxis against tumor lysis syndrome

Question 17

What is the MOA of Allopurinol

Answer 17

Xanthine oxidase inhibitor. (Decreases the production of uric acid)

Question 18

What drug class is Probenecid (Probalan)

Answer 18

uricosuric

Question 19

What is the MOA of probenecid (probalan)

Answer 19

interfers with the kidneys’ organic anion transporter (OAT), which reclaims uric acid from the urine and returns it to the plasma, thereby increasing excretion of uric acid in the urine

Question 20

Who is most at risk for serious side effects from probenecid (probalan)

Answer 20

Someone with a G-6-PD deficiency

Question 21

What are significant side effects of probenecid (probalan) use (2)

Answer 21

1. Formation of uric acid renal stones (particularly in someone with renal insufficiency). patient should drink extra water to prevent stone formation.
2. Exacerbation of gout following therapy with Probenecid may occur.

Question 22

Who always has elevated uric acid levels

Answer 22

Someone with a solid tumor, but particularly people with ALL, are at risk for acute renal failure due to increased uric acid from lysing the tumor(s).