Hyperuricemia and Gout - Chapter 17 Flashcards
Hyperuricemia
-A condition in which urate (uric acid) levels build up in the blood stream
Gout
-The primary disease associated with Hyperuricemia
Pathophysiology of Gout
- Hyperuricemia causes urate crystals to be deposited in joints, producing inflammation and pain
- “Disease of Kings” or “Rich Man’s Disease”
Drugs Used to Treat or Prevent Gout or Hyperuricemia
- Analgesics
- Antiinflammatories
- Uricosurics
- Inhibitors or uric acid synthesis
- Uric acid metabolizer (for hyperuricemia due to chemotherapy)
Analgesics and Antiinflammatory Drugs Examples
- colchicine
- NSAIDS
- Glucocorticosteroids
Colchicine
- Use limited to gout
- For gout flare; must start within 36 hours to be effective
Colchicine ADR’s
- n/v
- Bone marrow depression
- Neuropathy
- Muscle damage
- Multiple organ failure
- Death
Colchicine Warning Labels
- AVOID ALCOHOL
- AVOID GRAPEFRUIT
- TAKE WITH LOTS OF WATER
NSAIDS Used for Gout
-Most commonly prescribed is indomethacin, but any NSAID may be used
Brand: Indocid
Generic: indomethacin
Glucocorticosteroids for Gout
- Oral glucocorticosteroids such as prednisone, dexamethasone, or hydrocortisone may be used
- Intraarticular injections may be given when only 1 or 2 joints are affected
Glucocorticosteroids for Gout Examples
- methylprednisolone
- triamcinolone
Brand: Medrol, Depo-Medrol, Solu-Medrol
Generic: methylprednisolone
Brand: Kenalog
Generic: triamcinolone
Uricosurics
- Increase the clearance of uric acid by inhibiting the reabsorption of uric acid in the renal tubules and promoting the renal elimination or urates
- PREVENTATIVE ONLY (Not for treatment)
Uricosurics Examples
- probenecid
- sulfinpyrazone
Brand: Benuryl
Generic: probenecid
Brand: sulfinpyrazone, Anturan
Generic: sulfinpyrazone
Uricosurics ADR’s
- N/V
- Worsening of kidney stones
Uricosurics Warning Labels
- TAKE WITH FOOD
- AVOID ASA
- TAKE WITH LOTS OF WATER
Xanthine Oxidase Inhibitors MOA
-Block final step in synthesis of uric acid
Xanthine Oxidase Inhibitors Examples
- allopurinol
- febuxostat
Brand: Zyloprim
Generic: allopurinol
ADR’s:
- nausea
- drowsiness
- headache
- diarrhea
- itchy skin
Brand: Uloric
Generic: febuxostat
ADR’s:
- gout flare up
- N/V
- appetite changes
- angina
- MI
- stroke
Xanthine Oxidase Inhibitors Warning Labels
- TAKE WITH FOOD
- TAKE WITH LOTS OF WATER
- MAY CAUSE DIZZINESS OR DROWSINESS
- AVOID ALCOHOL
Uric Acid Metabolizer Examples
-rasburicase
Brand: Fasturek
Generic: rasburicase
-For hyperuricemia due to chemotherapy
