Gout Study Guide

Question 1

Meds increasing risk of gout

Answer 1

Thiazide diuretics; Loop diuretics; Niacin; Pyrazinamide; Cyclosporine; Aspirin

Question 2

Acute gout management

Answer 2

1st = Indomethacin; 2nd = Colchicine; 3rd = Steroids

Question 3

When to avoid NSAIDS in gout management

Answer 3

Renal; CHF; PUD; HTN

Question 4

Colchicine MoA

Answer 4

Reduces inflammation by inhibiting phagocytosis (interferes with mitotic spindles in neutrophils)

Question 5

Drawbacks of Cholchicine Tx

Answer 5

Expensive; Major GI ADEs; Requires monitoring (CBC, Renal)

Question 6

Steroid for acute gout attack

Answer 6

Oral prednisone taper x 2wks

Question 7

When to start gout prophylaxis

Answer 7

Freq. attacks; Tophi; Joint destruction; Nephrolithiasis

Question 8

1st line gout prophylaxis

Answer 8

Allopurinal

Question 9

Allopurinol MoA

Answer 9

Decreases uric acid formation (Xanthinase oxidase inhibitor&raquo_space; Prevents conversion of xanthine)

Question 10

Allopurinol Interactions

Answer 10

Azathioprine; WARFARIN; Ampicillin

Question 11

Major ADE of Allopurinol

Answer 11

Stevens-Johnson Syndrome

Question 12

Allopurinol monitoring

Answer 12

Serum Uric Acid & BUN/Cr

Question 13

2nd line gout prophylaxis

Answer 13

Febuxostat (Uloric)

Question 14

Febuxostat (Uloric) MoA

Answer 14

Same as Allopurinol: decreases uric acid formation by inhibiting xanthine oxidase

Question 15

Febuxostat (Uloric) Drawbacks

Answer 15

Expensive; Increased LFTs

Question 16

Other Gout Prophylaxis Tx

Answer 16

Probenecid; Pegloticase (Krystexxa)

Question 17

Probenecid MoA

Answer 17

Increases Uric Acid excretion (rarely used)

Question 18

Pegloticase (Krystexxa) Drawbacks

Answer 18

Expensive ($20,000/yr); IV only