Gout medications Flashcards
What causes elevated uric acid
Making too much or not getting rid of it effectively
What do urocusuric class medications do
increases urine secretion of uric acid
What does an anti-urocusuric class of drug do
Withhold uric acid from the urine (aspirin, HCTZ, lasix)
What treatment is used in an acute gouty attack
NSAIDs
Steroids
Colchicine
What treatments can be used as gout attack prophylaxis
Colchicine
Allopurinol
Probenecid
What drug class is Indomethacin
NSAID
What are the indications of indomethacin
Gout, arthritis, bursitis, migraines, hemicrania, pain and swelling
What is the MOA of cortisone injection
Inhibits pro-inflammatory proteins
What are some side effects of intra-articular cortisone injections
pain, infection, skin pigment changes, loss of fatty tissue and tendon rupture. (Plus all the usual systemic side effects)
What drug class is colchicine
Mitotic inhibitor
What is the indication for using colchicine
Gout, acute and prophylaxis
What is MOA of colchicine
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
What are some side effects of colchicine
Marked GI upset, Peripheral neuropathy, hair loss, anemia, neutropenia
What are colchicine OD symptoms
vomiting, diarrhea, acute renal failure and possible hypovolemic shock. put the patient on dialysis because there is no antidote
What drug class is allopurinol (zyloprim)
purine analog
What are the indications for allopurinol (zyloprim)
hyperuricemia, gout, prophylaxis against tumor lysis syndrome
What is the MOA of Allopurinol
Xanthine oxidase inhibitor. (Decreases the production of uric acid)
What drug class is Probenecid (Probalan)
uricosuric
What is the MOA of probenecid (probalan)
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
Who is most at risk for serious side effects from probenecid (probalan)
Someone with a G-6-PD deficiency
What are significant side effects of probenecid (probalan) use (2)
- Formation of uric acid renal stones (particularly in someone with renal insufficiency). patient should drink extra water to prevent stone formation.
- Exacerbation of gout following therapy with Probenecid may occur.
Who always has elevated uric acid levels
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).
