Pharm- Gout

Question 1

Explain the general therapy of acute gout using anti-inflammatory agents

Answer 1

Acute Gout

• start w/ NSAIDs- naproxen and indomethacin
• next use Colchicine
• next use Glucocorticoids

Question 2

Explain general preventioin treatment of recurrent gout

Answer 2

• lifestyle changes to reduce urate

- drugs

Question 3

NSAIDs used for acute gout and when do you start them

Answer 3

Naproxen, indomethacin, and celecoxib

Start w/in 48 hr of onset

Question 4

Colchicine
MOA
Uses
AE
CI

Answer 4

Colchicine
MOA- binds tubulin to block microtubule formation which will inhibit leukocyte migration
Uses- used for acute gout in pt intolerant to NSAIDs
AE- GI
CI- renal/hepatic impairment

Question 5

Explain the urate-lowering treatment of gout?

Answer 5

Start w/ allpurinol, switch to febuxostat if allopurinol is not tolerated, then as last resort use pegloticase

Question 6

Allopurinol
MOA
Uses
AE

Answer 6

Allopurinol
MOA- met into alloxanthine which inhibits xanthine oxidase to inc excretion of hypoxanthine and xanthine
Uses- recurrent gout and chem-induce hyperuricemia
AE- rash, acute gout, hypersensitivity if HLA-B+ (asian)

Question 7

Febuxostat
MOA
Uses

Answer 7

Febuxostat
MOA- inhibits xanthine oxidase to in excretion of xanthine and hypoxanthine
Uses- use in pt who don’t tolerate allopurinol

Question 8

Pegloticase
MOA
Uses
Kinetics
AE

Answer 8

Pegloticase
MOA- attaches to methoxypolyetheylene glycol to convert uric acid into allantoin
Uses- chronic gout refractory to conventional therapy
Kinetics- IV every 2 wks
AE- infusion rxn (premed w/ gluco or antihistamine), acute gout

Question 9

Probenecid
MOA
uses
AE

Answer 9

Probenecid
MOA- blocks urate reabsorption, inc fractional excretion of urate and dec plasma urate concentration
Uses- urate underexcreters w/ GFR>60 w/o stones
AE- kidney stones, acute gout, sulfa hypersensitivity