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PBL > PHARM 48 > Flashcards

PHARM 48 Flashcards

1
Q

What is the most important determinant of purine synthesis?

A

cellular levels of PRPP

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2
Q

Transfers PRPP to hypoxanthine or guanine

A

HGPRT (salvage pathway)

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3
Q

Catalyzes reaction of PRPP with glutamine

A

amidoPRT

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4
Q

What is the action of xanthine oxidase?

A

converts xanthine to uric acid

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5
Q

What is lesch-nyhan syndrom and what is its cause?

A

absence of HGPRT– self mutilation, mental retardation, hyperuricemia

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6
Q

how is uric acid eliminated?

A

kidneys (65%) GI (35%)

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7
Q

where is URAT1 expressed

A

expressed in proximal renal tubule for reabsorption

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8
Q

What are the 4 stages of gout?

A
  1. asymptomatic hyperuricemia
  2. acute gout
  3. intercritical phase
  4. chronic gout
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9
Q

Gout due to increased synthesis or decreased breakdown of purines

A

asymptomatic hypercurcemia stage 1

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10
Q

acute arthritic attack of single joint (podagra)

A

acute gout (stage 2)

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11
Q

asymptomatic hyperuricemia

A

intercritical phase (stage 3)

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12
Q

hyperuricemia w/ development of tophi (UA crystals) recurrent gout attacks

A

chronic gout (stage 4)

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13
Q

Why are joints favorable to UA crystal formation?

A

lower temperature and more acidic

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14
Q

NSAID used to treat gout

A

indomethacin

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15
Q

Drugs to treat stage 2

A

NSAIDs, colchicine, glucocorticoids

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16
Q

Drugs to treat stage 4

A

allopurinol
probenecid
sulfinpyrazone

17
Q

What does urate crystal binding in monocytes initate the assembly of?

A

NALP-3 inflammasome —> Activates caspase 1

18
Q

Colchicine and glucocorticoids treat

A

acute gout

19
Q

binds to tubulin to inhibit intra cellular trafficking and there fore decreases inflammatory response

A

cholchine

20
Q

Inhibits conversion of hypoxanthine to xanthine –> UA

A

allopurinol

21
Q

increases Urate excretion by inhibiting URAT 1 receptor

A

probenecid

sulfinpyrazone

22
Q

More potent than probenecid but works same way

A

sulfinpyrazone

23
Q

Main risk factor for benxbromarone

A

hepatotoxicity

24
Q

angiotensin II receptor antagonist w/ uricosuric effects

A

Losartan

25
Q

Probenecid, sulfinpyrazone, benxbromarone, losartan are examples of

A

Uricosuric agents

26
Q

may be injected to inflamed joint for treatment of acute gout

A

Mthylprednisolone

27
Q

2 drugs that increase azathioprine, 6-mercaptopurine

A

allopurinol and oxypurinol

28
Q

nonpurine small molecule inhibitor of xanthine oxidase

A

Febuxostat

29
Q

Recombinant form of Aspergillus uricase, converts urate to more soluble allantoin

A

Rasburicase

30
Q

What gout drug is contraindicated in pregnancy?

A

Losartan

31
Q

what chronic gout drug is contraindicated for acute gout?

A

sulfinpyrazone

probenecid

PBL (19 decks)

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