Sketchy Pharm: Gout Drugs Flashcards

1
Q

What two reactions does xanthine oxidase catalyze?

A

Hypoxanthine to xanthine and then xanthine to uric acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why are NSAIDs used to treat gouty attacks?

A

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.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Other than NSAIDs, what can be used to treat gouty attacks?

A

Corticosteroids

Think of the moon facies in the basin of water that the priest is falling into after tripping on the uric acid yarn.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Colchicine inhibits cells’ ability to ______________.

A

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.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Colchicine has a mechanism analogous to what other drugs?

A

Vincristine and vinblastine (both prevent polymerization of microtubules)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What side effect is most common with colchicine use?

A

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.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Histologically, how can you differentiate between gout and pseudogout?

A

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 well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does allopurinol work?

A

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.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What drug other than allopurinol works by inhibiting xanthine oxidase?

A

Febuxostat (“It puts a stop to XO, STAT!”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Tumor lysis syndrome presents with elevations of what serum values?

A

K
Phos
Urate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tumor lysis syndrome most commonly occurs from the treatment of which two cancers?

A

T-cell lymphoma and leukemia?

Think of the crusaders with Ts on their WHITE shirts –like WBCs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why do those with Lesch-Nyhan injure themselves?

A

Uric acid accumulates in the skin and lips and causes pain. Patients will bite or scratch to relieve the pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Be careful giving allopurinol to someone receiving _______________.

A

drugs that are purine analogues, such as 6-mercaptopurine and azathioprine

(Think of the PURe nuns wearing the purine-analogue rosaries.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What side effects can allopurinol cause?

A

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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What drug works to treat chronic gout by inhibiting the reabsorption of urate from the proximal renal tubule?

A

Probenecid (like Cid the PROBation officer who takes cons to church and is preventing them from stealing the ball of yarn)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Probenecid increases risk of _____________.

A

uric acid stone formation

17
Q

What is a potential DDI of probenecid?

A

It prevents the excretion of some drugs (notably penicillin), thus prolonging their half-lives.

(Think of the “drugs” tattoo on the convict’s arm and the large pencil on Cid’s lap.)

18
Q

Probenecid can trigger __________ allergies.

A

sulfur (think of the kid throwing rotten eggs)

19
Q

Low-dose aspirin can cause _____________, while high-dose aspirin can cause ______________.

A

inhibition of uric acid excretion; inhibition of uric acid reabsorption

(Think of the ASA coach –who represents high-dose aspirin –preventing the kid from reabsorbing the yarn and the coach’s kid – who represents low-dose aspirin –preventing the excretion of yarn.)

20
Q

Pegloticase can treat refractory gout by ______________.

A

converting uric acid into the water-soluble allantoin

Think of the holy water next to the yarn –”water to GO… just in CASE”

21
Q

What side effects does pegloticase have?

A

Triggering hemolytic anemia in those with G6PD deficiency and anaphylaxis