L89 - Crystal Arthropathies

Question 1

Acute therapy for gout (decreases inflammation). Better tolerated than colchicine

Answer 1

NSAIDs

Question 2

Inhibits microtubule formation
Inhibits assembly of NLRP3 inflammasome
Turns off cytokine cascade
Decreases inflammatory response

Answer 2

Colchicine

Question 3

SE of colchicine

Answer 3

NVD (nausea, vomitting, diarrhea), marrow suppression; death, hepatitis, seizures, respiratory depression, alopecia

Question 4

Xanthine oxidase inhibitor (XOI) - 2 drugs

Answer 4

Allopurinol and febuxostat

Question 5

Mechanism of XOI

Answer 5

Stop purine metabolism so uric acid doesn’t form

Question 6

Alternative to XOI when XOI contra-indicated or not tolerated

Answer 6

Probenecid (Uricosuric)

Question 7

Acute therapy for gout that reduces inflammation, but not NSAID

Answer 7

Corticosteroids (prednisone)

Question 8

Persistent activity despite (or intolerance to) combination urate lowering therapy
Other option for gout

Answer 8

Pegloticase (uricase)