Sketchy Pharm: Gout Drugs Flashcards
What two reactions does xanthine oxidase catalyze?
Hypoxanthine to xanthine and then xanthine to uric acid
Why are NSAIDs used to treat gouty attacks?
Because the accumulation of uric acid crystals causes the release of prostaglandins
(Think of the altar boy spraying the other priest with the NSAID fire extinguisher.)
Other than NSAIDs, what can be used to treat gouty attacks?
Corticosteroids
Think of the moon facies in the basin of water that the priest is falling into after tripping on the uric acid yarn.
Colchicine inhibits cells’ ability to ______________.
phagocytose crystals, degranulate, and migrate to sites of inflammation
(Think of the neutrophil first responders who are unable to get past the colchicine choir to the uric acid crystals.)
Colchicine has a mechanism analogous to what other drugs?
Vincristine and vinblastine (both prevent polymerization of microtubules)
What side effect is most common with colchicine use?
Diarrhea, because the fast-dividing cells of the GI tract will be killed by colchicine
(Think of the diarrhea-evoking mud trailed in by the first responders near the colchicine choir.)
Histologically, how can you differentiate between gout and pseudogout?
Pseudogout is calcium pyrophosphate crystals that are rhomboid and positively birefringent, while gout is uric acid crystals are needle-shaped and negatively birefringent.
(Think of the rhomboid-shaped incense –fragrance, get it? –holder next to the ten commandments plate with the injunction to not lie… just like how pseudogout lies about being gout.)
How does allopurinol work?
It is a xanthine oxidase inhibitor that prevents the accumulation of uric acid.
(Think of the PURe nun who it removing the XO notes being passed around the pews.)
What drug other than allopurinol works by inhibiting xanthine oxidase?
Febuxostat (“It puts a stop to XO, STAT!”)
Tumor lysis syndrome presents with elevations of what serum values?
K
Phos
Urate
Tumor lysis syndrome most commonly occurs from the treatment of which two cancers?
T-cell lymphoma and leukemia?
Think of the crusaders with Ts on their WHITE shirts –like WBCs.
Why do those with Lesch-Nyhan injure themselves?
Uric acid accumulates in the skin and lips and causes pain. Patients will bite or scratch to relieve the pain.
Be careful giving allopurinol to someone receiving _______________.
drugs that are purine analogues, such as 6-mercaptopurine and azathioprine
(Think of the PURe nuns wearing the purine-analogue rosaries.)
What side effects can allopurinol cause?
SJS (think of the nun removing the boy’s red mask) and dress syndrome –characterized by eosinophilia, fever, and lymphadenopathy (think of the girl in the pink [eosinophilic] DRESS who is eo-slingshotting the nun)
What drug works to treat chronic gout by inhibiting the reabsorption of urate from the proximal renal tubule?
Probenecid (like Cid the PROBation officer who takes cons to church and is preventing them from stealing the ball of yarn)