L10. Urate Metabolism

Question 1

Allopurinol

Answer 1

Competitive xanthine oxidase inhibitor

Treats chronic gout and hyperuricemia

SE: hypersensitivity

Asians get steven johnson

Initially NSAID/ colchicine

Question 2

Febuxostat

Answer 2

Non competitive xanthine oxidase inhibitor

Treats chronic gout

SE: low hypersensitivity
high CVD lethality and high lethality in general

Initially NSAID/ colchicine

Question 3

Probenecid

Answer 3

Inhibits URATE - 1
(Dec urate reabsorbption)

Treats chronic gout

SE: urate kidney stone, rash, br br stomach

CI: avoid in kidney disease

Initially NSAID/ colchicine

Question 4

Pegloticase

Answer 4

Recombinant uricase
(Breaks down urate)

Into allantoin (water soluble non toxic metabolite)

Treats chronic gout

SE: infusion rxn/ anaphylaxis
Hemolysis/ methemoglobinemia in patients with G6PD deficiency

Initially NSAID/ colchicine

Question 5

Colchicine

Answer 5

Binds tubulin and mitotic spindle (inhibits neutrophil migration and cell division)

Treats and prevents ACUTE gout

SE: diarrhea and granulocytopenia

Broken down by 1A2!!

Question 6

When is probenecid harmful?

Answer 6

Kidney disease

Due to risk of urate kidney stome

Question 7

When is pegloticase harmful?

Answer 7

G6PD deficient patients

Due to risk of hemolysis and methemoglobinemia

Question 8

Which is the only urate drug that treats acute gout?

Answer 8

Colchicine

Question 9

Urate metabolism channels and effect (2)

Answer 9

OAT: secreting drugs into proximal tubule (as well as penicillin and cyclosporin)

URAT 1: inhibited by probenecid