Gouty Drugs

Question 1

Drugs for Gout

Answer 1

Colchicine
Allopurinol
Febuxostat
PEG-uricase
Probenecid

Question 2

Colchicine - indication

Answer 2

High dose - treatment of acute gouty arthritis

Low dose - prevention of recurrent gouty arthritis

Question 3

Colchicine - MoA

Answer 3

Prevents microtubule polymerization

Prevents Neutrophil chemotaxis to gout site

Question 4

Colchicine - adverse effects

Answer 4

1. GI (nausea/vom/pain)
2. Hematologic (agranulocytosis, aplastic anemia, thrombocytopenia)
3. muscular weakness

*Dose related and exacerbated with hepatorenal disease

Question 5

Allopurinol - MoA

Answer 5

inhibits xanthine oxidase to decrease uric acid production

Question 6

Allopurinol - common rxns

Answer 6

GI
Acute gout attacks
Rash

Question 7

Allopurinol - serious rns

Answer 7

Fever, rash, toxic epidermal necrolysis
Hepatotoxicity, marrow suppression
Vasculitis
Drug interactions (amp, thiazides, mercaptopurine, azathioprine)
Death

Question 8

Allopurinol - extremely serious problem

Answer 8

hypersensitivity - skin rash appears first and may progress to toxic epidermal necrolysis and death

Renal impairment increases chances

Question 9

Febuxostat - MoA

Answer 9

oral xanthine oxidase inhibitor

Question 10

Febuxostat - adverse

Answer 10

minimal

can be used with renal impairment

Question 11

PEG-uricase - indication

Answer 11

treatment resistant gout (intravenous)

Question 12

PEG-uricase - MoA

Answer 12

speeds resolution of tophi

Question 13

Probenecid - indication

Answer 13

Mild gout

Question 14

Probenecid - MoA

Answer 14

blocks tubular reabsorption of uric acid

Question 15

Probenecid - adverse effects

Answer 15

nephrolithiasis (dont use in renal disease)

Question 16

Drug to use for renal disease

Answer 16

Febuxostat