Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Gout Therapy > Flashcards

Gout Therapy Flashcards

1
Q

Recurrent episodes of pain and joint inflammation due to formation os crystals and deposition of those crystals in soft tissues is…

A

Gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is deposited in gout?

A

Monosodium urate monohydrate (MSU( crystals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the cause of gout?

A

Hyperuricemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Deposition of calcium pyrophosphate (CPP) crystals is associated with…

A

Pseudogout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What disorder is also referred to as Calcium Pyrophosphate Disease (CPPD)

A

Pseudogout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

T or F: Humans lack the enzyme uricase.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Uricase function:

A

turns uric acid to allantoin (soluble form)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What enzyme is responsible for conversion of Hypoxanthine –> Xanthine –> Uric Acid?

A

Xanthine oxidase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the drug that acts on xanthine oxidase function?

A

Allopurinol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Intermittent acute attacks that spontaneously resolve typically over a period of 7-10 days with asymptomatic periods between attacks is ______ gout

A

Phase 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Inadequately treated hyperuricemia can cause a transition to _____ gout

A

Second Phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which gout phase is manifested as chronic tophaceous gout which often involves polyarticular attacks, symptoms between attacks, and crystal deposition (tophi) in soft tissues or joints?

A

Second phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Severe degenerative arthritis, secondary infections, urate or uric acid nephropathy, nerve or spinal chord impingement, increased infection risk, renal stones, and fractures are…

A

Complications associated with gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

In acute gout, the aim is to…

A

relieve pain, prevent disease progression, and prevent tissue deposition of uric acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Top four options for managing acute gout attacks are:

A

NSAIDs
Colchicine
Glucocorticoids
(possibly) corticotropin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the first line treatments of acute gout attacks?

A

NSAIDs and colchicine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When NSAIDs or colchicine are poorly tolerated, you can use…

A

glucocorticoids or coticotropin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

You should not use ____ _____ drugs for treatment of acute gout

A

Urate lowering drugs

No benefit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Is Aspirin indicated for treating acute gout?

A

NO

low doses –> uric acid retention (bad)

high doses –> uricosuric effect (excretion of uric acid) which seems good but you need HIGH doses which is dangerous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Patients with hyperuricemia that have at least two gout attacks per year or presence of tophi (clinically or radiographically) have…

A

Chronic gout

21
Q

What is the aim for treatment of chronic gout?

A

lowering the serum urate levels

22
Q

What drugs are used for chronic gout?

A

Urate lowering therapy (ULT) continued indefinitely

23
Q

What urate level are you trying to maintain?

A

less than 6mg/dL

24
Q

What are the three classes of agents used for ULT?

A

Xanthine oxidase inhibitors

Uricosuric agents

Uricase agents

25
Q

Drugs that block production of uric acid?

A

Xanthine oxidase inhibitors

26
Q

Drugs that increase secretion of uric acid by increasing its concentration in urine?

A

Uricosuric agents

27
Q

Drugs that promote conversion to soluble form allantoin?

A

Uricase agents

28
Q

What ULT drug is first-line therapy?

A

xanthine oxidase inhibitors

29
Q

Allopurinol

A

Xanthine oxidase inhibitor

30
Q

Febuxostat

A

Xanthine oxidase inhibitor

31
Q

Probenecid and Lesinurad

A

Uricosuric Drugs

32
Q

What drugs are used less frequently than xanthine oxidase inhibitors and are contraindicated in patients with nephrolithiasis?

A

Uricosuric Drugs

33
Q

What drug is a combination of Uricosuric drug, Lesinurad, and a xanthine oxidase inhibitor, Allopurinol?

A

Duzallo

Fixed-dose oral combination for treatment of hyperuricemia

Used when patients don’t respond to only allopurinol

34
Q

Pegloticase

A

Uricase Agent

Polyethylene glycolated modified porcine recombinant uricase

35
Q

How is pegloticase administered?

A

Intravenously

Uricase agent

36
Q

Infusion reactions are common for…

A

Uricase agent, Pegloticase, which is given IV

37
Q

What are some non-pharmacologic therapies for gout treatment?

A

To decrease serum urate levels, you can avoid alcohol or modify diet by eating less meat (high purine –> uric acid)

38
Q

What diet is associated with less consumption of red meat and more consumption of fruits and vegetables?

A

DASH diet

fruits and veggies –> increase vit C

39
Q

In pseudogout, do you see elevated serum urate levels?

A

No! It’s different from gout. You have CPP depositions that are rhomboid shaped

40
Q

Colchicine MOA is…

A

inhibition of microtubule assembly

41
Q

Colchicine should NOT be used in patients with…

A

Advanced renal or hepatic impairment

42
Q

If a patient has active peptic ulcer disease or history of NSAID intolerance, what drug should you use to treat acute gout flares?

A

Colchicine

43
Q

What drug has a symptom of mild rash, can cause leukopenia or thrombocytopenia, diarrhea, acute gouty arthritis?

A

Allopurinol

44
Q

Allopurinol is used more than febuxostat because…

A

it is less expensive

45
Q

Probenecid MOA is…

A

Promotes renal clearance of uric acid by inhibiting urate anion exchanges (including URAT1) in the proximal tubule that mediates urate reabsorption

Increases urate excretion

Uricosuric agent

46
Q

Nephrolithiasis or uric acid nephropathy are contraindications for…

A

Probenecid

Uricosuric agent

47
Q

MOA of Lesinurad is…

A

Inhibits activity of URAT1 and OAT4 in vitro, does not inhibit GLUT9 or ABCG2

Unlike probenecid, it doesn’t inhibit OAT1 or OAT3 in clinical setting

48
Q

What drug is often administered with allopurinol?

A

Lesinurad

49
Q

Pegloticase

A

Recombinant uricase agent which converts uric acid to allantoin

Pharmacology (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions