Hyperuricaemia And Gout

Question 1

What is gout?

Answer 1

Condition that causes sudden severe pain, swelling and redness in the joints, caused by the accumulation of uric acid crystals forming in the joints

Question 2

What drugs cause hyperuricaemia?

Answer 2

Diuretics - loop and thiazide
Ciclosporin 
Tacrolimus
Cytotoxics
Cancer

Question 3

What is used to treat and acute attack of gout?

Answer 3

NSAIDs but not aspirin

Colchicine

Question 4

What is the regime for colchicine when being used for gout?

Answer 4

Do not repeat course in 3 days
Max dose 500 mcg 2-4 times a day
Max 6mg per course

Question 5

What is used to prevent gout?

Answer 5

Xanthine oxidase inhibitors

Allopurinol
Febuxostat

Uricosuric drugs
Sulfinapyrazone

Question 6

What are the side effects of febuxostat?

Answer 6

Serious hypersensitivity reactions

Question 7

What are the side effects of sulfinapyrazone?

Answer 7

Makes urine alkaline, allowing urea crystals to form

Ensure adequate renal function and urine output

Question 8

When do you start gout prophylaxis?

Answer 8

Never start during an acute attack, initiate 1-2 weeks after

Initiation may precipitate an acute attack

If attack occurs during prophylaxis continue as normal and treat attack separately

Question 9

What is allopurinol?

Answer 9

Xanthine oxidase inhibitor

Question 10

What are the side effects of allopurinol?

Answer 10

Rashes

Question 11

How do you take allopurinol?

Answer 11

With or after food

Question 12

What are the interactions with allopurinol?

Answer 12

Reduce dose of mercaptopurine/azathioprine by 1/4 to 1/2 as increased risk of toxicity