Pharm - Gout

Question 1

acute gout attack goals

Answer 1

managing inflammation

Question 2

chronic hypERuricemia

Answer 2

lowering uric acid

Question 3

colchicine

MOA/AE

Answer 3

MOA: microtubule inhibitor, downregulates TNF/blocks COX2, inhibits wbc migration

AE: GI (N/V/D, abd pain)
neuromyopathy mimicking polyangitis (rare)

Question 4

If a patient cannot tolerate NSAIDS because of such issues as hypersensitivity, fluid overload, renal insufficiency, or peptic ulcer disease, then _______ are acceptable alternatives most commonly used.

Answer 4

colchicine and glucocorticoids

Question 5

____ is used for tx of acute gout attacks (as well as for prophylaxis against new attacks)

Answer 5

Colchicine

Question 6

____ must be given in first 24 hr of gout attack

Answer 6

Colchicine

Question 7

____ are two drugs which reduce production of uric acid and are indicated for chronic therapy in patients with problems of over-production of uric acid.

Answer 7

Allopurinol and febuxostat

Question 8

____ are uricosuric agents indicated for patients who are under-excreters of uric acid.

Answer 8

Probenecid and sulfinpyrazone

Question 9

refractory gout tx

Answer 9

IL-1 inhibitors (anakinra, canakinumab)

Question 10

indic for pharm tx of chronic hypERuricemia

Answer 10

• 2+ attacks in past year
• uric acid kidney stones
• tophi
• renal insufficiency
• CHF necessitating long-term, or a very serum uric acid

Question 11

uricosuric agents

Answer 11

probenecid

lesinurad

Question 12

XO inhibitors

Answer 12

allopurinol

febuxostat

Question 13

urate oxidase enzyme

Answer 13

pegloticase

Question 14

genetic predisposition to severe allipurinol toxicity

Answer 14

HLA B5801