HYPERURICAEMIA + GOUT

Question 1

what is hyperuricaemia + GOUT

Answer 1

• raised uric acid conc in blood (hyperuricaema)
• deposition of urate crystals in joints + other tissues

Question 2

causes of hyperuricaemia + GOUT

Answer 2

• diet high salt intake
• medications = bendroflumethiazide/chemo drugs

Question 3

hyperuricaemia + GOUT acute tx

Answer 3

start ASAP
- colchicine OR high dose of NSAIDs + PPI (not aspirin)

Question 4

dose of colchicine in acute attack

Answer 4

• 500mcg BD/QDS max 3DY
• do not repeat course within 3DY

Question 5

NSAID interaction

Answer 5

NSAIDs induces fluid retention therefore interacts with diuretics

Question 6

alternative tx of acute attack

Answer 6

• short course of oral corticosteroids
• IM injection of corticosteroids or canakinumab

Question 7

what is considered chronic attack

Answer 7

frequent acute attacks of GOUT = 2 or more in one year

Question 8

what may reduce uric acid

Answer 8

xanthine-oxidase inhibitors allopurinol

Question 9

1st line of chronic attack

Answer 9

allopurinol

Question 10

2nd line of chronic attack

Answer 10

febuxostat

Question 11

febuxostat caution

Answer 11

Caution with febuxostat use in patients with a history of major cardiovascular disease

Question 12

what to do if acute attack during tx of chronic tx

Answer 12

continue chronic tx and tx acute attack separately

Question 13

what is given as flare-prohylaxis with allopurinol

Answer 13

cochicine or NSAID

Question 14

s/e of allopurinol

Answer 14

rash = discontinue but if mild restart carefully but discontinue if immediately if recurrence

Question 15

interaction of allopurinol

Answer 15

• azathioprine + mercartopurine
• reduce dose of aza/merc