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SUMPHARM > PAIN-Gout > Flashcards

PAIN-Gout Flashcards

1
Q

What cause DEC renal excretion of UA?

A 
Etoh, 
cyclosporin, 
ethambutal, 
pyrasinamed, 
aspirin, 
levodopa, 
niacin.
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2
Q

What cause INC production of UA?

A

Ethanol/ETOH, cytoxic drugs, VB12. meats, obese,

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3
Q

Which DOC NSAID for acute gout are AVOIDED if ARF?

A

Indomethacin, Sulindac, Naproxen

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4
Q

What PO corticosteroid is used of Acute gout?

A

Prednisolone. Intrarticular if multi jt or NPO pts.

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5
Q

This ANTI inflammatory ACUTE gout med MOA is unknown, NO ANALGESIC effects. **MAY inhibit leukocyte migration inhibition. (Choir blocking EMT)

A

Colchicine

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6
Q

What is the dose for Colchicine?

A

**Acute- 1.2mg, then 0.6mg 1hr later Prevent: 0.6mg 12hrs later. OR 0.6 PO BID til gone

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7
Q

What is main SE for Colchicine?

A
  1. Diarrhea VC 77%.
  2. DO not adjust dose RENAL and HEPATIC dfxn. CRCL <30 dec dose, dec 2wk
  3. Avoid STRONG CYPs ie. cyclosporin or clarithromycin, grapefruit juice-INC Toxicity
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8
Q

What is last resort for ACUTE GOUT if renal?

A

IL Blockers- Rilonacept Anakinra

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9
Q

This has a BBW for CV Death and used in Chronic Gout/hyperuricemia used if allergic to others?

A

Febuxostat

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10
Q

Who is consider for Urate lowering therapy?

A
  1. Tophus on PE or image
  2. > 2/yr
  3. Urolithiasis.
  4. NOT FOR ACUTE!!
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11
Q

Which *1st LINE CHRONIC TX inhibits xanthine XO enzyme that converts two steps to uric acid?

A

Allopurinol

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12
Q

What is Allopurinol Dose for pt *overproducing uric acid?

A

Prohylasix- 100mg/d titrate Q2-5W until UA<6. MAX 800. Elderly and Renal dose adjust

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13
Q

What should you warn pts w/ dosing?

A
  1. May have acute attack
    2.SJS rash d/c
  2. Leukopenia
  3. N/V/D
    5 INC LFTS
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14
Q

What may have INC levels with use of alluprinol?

A

Azathioprine, Cyclopsoin, theophyline. Warfarin

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15
Q

Which ULT RX are used for underexcretors of UA?

A

Probenecid, Sulfinpyrazone, Lesinurad.

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16
Q

How do underexcretors work?

A

inhibit reabsorption of uric acid, INC excretion in urine

17
Q

This UA excretion works in proximal tubule, LOT of H2O, HCO3, Kcitrate are req maintain alkaline urine?

A

Probenecid (Benemid®)

18
Q

This MAX DOSE is 2g/d with this SE?

A

Probenecid

Kidney stone, acute gout, N/V/D rash

19
Q

What is CAUTION for DI with uricosurics?

A

Aspirin and Diuretics
DEC effectiveness, slow UA renal secretion.
CrCl <30 loss efficacy

20
Q

Thiazide diuretics and ABX mix with allopurinol affect what?

A

hypersensitivity

21
Q

This uricourics for underexcterors is caution kidney stones?

A

Sulfinpyrzone

22
Q

What can be used with Allopurinol XO inhib?

A

Lesinurad- caution Kidney stones, ARF, Leshch Nyan syndrome (tumor lysis)

23
Q

What is advised if need to use Febuxostat?

A

Combine with NSAID or colchicine up to 6m

24
Q

This drug is synthetic uricase that is an enzyme absent in humans. This enzyme breaks down uric acid to a metabolite for renal excretion, BUT it does not inhib uric prodcution?

A

Pegloticase- IV Q2W. DO NOT USE w. other ULTs.

25
Q

During Tx with ULT what can be used to lower risk of acute flares of gout?

A

NSAIDs or Colchicine

26
Q

Due to pegloticase infusion, what are ADR?

A
  1. G6PD dfx
  2. Acute gout flare
  3. Infusion rx
  4. VC antibody formation
27
Q

What tX are used for OA?

A
  1. APAP
  2. NSAIDs, Cox, Salicylate
  3. Corticosteroid
  4. Tramadol
  5. Intraarticul hyaluronic acid
28
Q

What tX are used for RA?

A
  1. NSAIDs
  2. Corticosteroid
  3. DMARD
29
Q

What tX are used for PsA?

A
  1. NSAIDs

2. DMARD

30
Q

What tX are used for AS?

A
  1. Local Corticosteroid

2. DMARD

31
Q

What tX are used for Gout?

A
  1. Uricosuric-Probenecid, Sulfinpyrazone, Lesinurad
  2. Allupurinol/Febuxostat
  3. Colchicine 4. NSAIDs

SUMPHARM (26 decks)

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