Lecture 6.5 Gout/Non-NSAIDS

Question 1

____ inhibits uric acid excretion and can cause acute gout. why can red meat cause acute gout?

Answer 1

alcohol;

has a lot of purines

Question 2

what enzyme is deficient in kids with Lesch Nyan?

this causes defective ____ ____

Answer 2

HGPRT;

purine salvage

Question 3

what cells are critical to acute gout

Answer 3

granulocytes ie PMN’s

Question 4

primary treatment for acute gout is ____. mechanism of action?

Answer 4

colchicine;

binds to tubulin and inhibits MT polymerization

Question 5

colchicine impairs granulocyte ____ and _____

Answer 5

chemotaxis, degranulation

Question 6

colchicine’s main side effect:

why does this happen

Answer 6

GI toxicity ie diarrhea;

toxic to rapidly proliferating intestinal epithelial cells

Question 7

2 other drugs used in acute gout. which should not be given?

Answer 7

NSAIDS such as ibuprofen, indomethacin and corticosteroids;

don’t give salicylates

Question 8

allopurional inhibits what enzyme? it is contraindicated in what?

Answer 8

xanthine oxidase;
acute gout (can prolong attack)

Question 9

______ also inhibits xanthine oxidase and is more efficacious than allopurinol

Answer 9

febuxostat

Question 10

____ promotes urinary excretion of uric acid by blocking reabsorption of urate. what can this cause?

Answer 10

probenecid;

uric acid stones (ie not for over producer)

Question 11

pseudogout is caused by deposition of _____. are these bifrengent or nah? pseudogout is very responsive to _____

Answer 11

calcium pyrophosphate dihydrate;
yes ;
nsaids

Question 12

gain of function mutations in ___ channels cause severe pain. loss of function mutations cause loss of pain sensation. where are these channels expressed?

Answer 12

voltage gated Na1.7;

peripheral nociceptive neurons

Question 13

lidocaine, bupivicaine, and benzocaine all block what? what are they used for?

Answer 13

Na channels;

local analgesia

Question 14

amitryptilline and carbamezipine are _____ used for chronic neuropathic pain. they block re-uptake of what?

Answer 14

tricyclic antidepressants;

serotonin, NE

Question 15

SNRIs prolong the ability of ____ to activate ____ receptors in the spinal chord. these are ____ coupled and inhibit pain

Answer 15

NE, alpha 2;

Gi

Question 16

duloxetine and venlafaxine are both _____. duloxetine is used especially for ____

Answer 16

SNRIs;

diabetic pain

Question 17

lamotrigine blocks ____ channels. it is associated with what side effect?

Answer 17

Na, Stevens Johnsons syndrome (SJS)

Question 18

Ziconotide, gapapentin, and pregabalin all block ____ channels. these thus block _____ and block pain transmission

Answer 18

Ca;

NT release

Question 19

capsaicin is an example of a _____ agonist

Answer 19

transient receptor potential (TRP)

Question 20

capsaicin is thought to _____ expression of TRPVI. these causes depletion of ____ upon chronic activation

Answer 20

reduce (desnsitize);

substance P