Gout treatment

Question 1

gout drugs are divided to

Answer 1

1. chronic gout drugs (preventive)

2. Acute gout drugs

Question 2

Acute gout drugs?

Answer 2

1. NSAID
2. Glucocorticoids
3. Colchicine

Question 3

acute gout drugs - which NSAIDs

Answer 3

naproxen

indomethacin

Question 4

acute gout drugs - glucocorticoids - way of administration

Answer 4

oral or intra-articular

Question 5

colhicine - mechanism of action

Answer 5

binds and stabilizes tubulin to inhibit microtubule polymerization, impairing neutrophil chemotaxis and degranulation

Question 6

colchicine - binds and stabilizes tubulin to inhibit microtubule polymerization, impairing …

Answer 6

impairing neutrophil chemotaxis and degranulation

Question 7

side effects of colchicine

Answer 7

GI upset

Question 8

colchicine action on gout

Answer 8

acute and prophylactic value

Question 9

salicilates - gout

Answer 9

do not salicylates –> all but the highest doses depress uric acid clearance. Even high doses (5-6g/day) have only minor uricosuric activity

Question 10

chronic gout drugs?

Answer 10

1. allopurinol
2. febuxostat
3. pegloticase
4. probenecid

Question 11

purine to urine (pathway and enzymes)

Answer 11

purine –> hypoxanthine –> xanthine (xanthine oxidase)

–> plasma uric acid (xanthine oxidase) –> URINE

Question 12

febuxostat - mechanism of action

Answer 12

inhibits xanthine oxidase

Question 13

allopurinol - mechanism of action

Answer 13

Competitive inhibitor of xanthine oxidase after being converted to alloxanthine

Question 14

allopurinol - active form

Answer 14

alloxanthine

Question 15

allopurinol - clinical use

Answer 15

1. chronic gout (prophylactic)
2. lymphoma
3. leukemia

Question 16

allopurinol - clinical use - lymphoma and leukemia?

Answer 16

prevent tumor lysis - associated urate nephropathy

Question 17

drugs that normally metabolised by xanthine oxidase

Answer 17

azathioprine

6-MP

Question 18

probenecid - mechanism of action

Answer 18

inhibits reabsorption or uric acid in proximal convoluted tubule
(also inhibits secretion of penicillin)

Question 19

probenecid - inhibits reabsorption or uric acid in

Answer 19

proximal convoluted tubule

Question 20

probenecid - inhibits secretion of

Answer 20

penicillin

Question 21

probenecid - side effect

Answer 21

it can precipitate uric acid calculi

Question 22

pegloticase - mechanism of action

Answer 22

recombinant uricase that catalyze metabolism or uric acid to allantoin (a more water-soluble product)

Question 23

pegloticase - recombinant uricase that catalyze metabolism or uric acid to

Answer 23

allantoin

Question 24

xanthise oxidase inhibitors

Answer 24

1. allopurinol

2. febuxostat

Question 25

uric acid - tubular reabsorption - inhibitors

Answer 25

1. probenecid

2. high doses of salicilates

Question 26

uric acid - tubular secretion - inhibitors

Answer 26

1. diuretics

2. low dose salicilates

Question 27

uric acid vs allantoin

Answer 27

allantoin is more water soluble product

Question 28

gout - drug that also inhibits the secretion of penicillin

Answer 28

probenecid

Question 29

recombinant uricase - drug

Answer 29

1. pegloticase

2. Rasburicase

Question 30

uricosuric activity ?

Answer 30

increase the excretion of uric acid in the urine