Therapeutic Considerations Flashcards
What is colchicine’s mechanism of action?
It inhibits microtubule formation by binding to tubulin heterodimers; this interrupts cellular motility and other processes necessary for neutrophil-mediated inflammatory response
Which drugs can increase plasma levels of colchicine?
cyclosporine, tacrolimus, verapamil
What drug can be injected into an inflamed joint for treatment of acute gout?
methylprednisolone
What is the mechanism of action of allopurinol?
It is an inhibitor and substrate for xanthine oxidase; the product of allopurinol oxidation (oxypurinol) also inhibits xanthine oxidase
allopurinol and oxypurinol increase levels of which other drugs?
azathioprine, 6-mercaptopurine
What is an important adverse effect of allopurinol?
rash with possibility of Stevens-Johnson syndrome
amoxicillin, ampicillin, and thiazide diuretics may increase the risk of severe rash
What is febuxostat’s mechanism of action?
It is a nonpurine small-molecule inhibitor of xanthine oxidase
Initiation of feboxostat therapy should be accompanied by which other drug?
a suppressive medications, such as colchicine, to reduce the risk of gout flares in the first several weeks
What is the mechanism of action of sulfinpyrazone and probenecid?
They inhibit renal tubule basolateral URAT1 anion exchanger, leading to increased excretion of uric acid
Sulfinpyrazone and probenecid increase levels of which other drugs?
penicillin and other organic anions
may increase levels of nitrofurantoin
What is the mechanism of action of losartan?
It is a angiotensin II receptor antagonist with a modest uricosuric effect
What is the mechanism of action of rasburicase?
It is a recombinant form of aspergillus uricase that converts sparingly soluble irate to more soluble allantoin
How does pegloticase compare to rasburicase?
It is a peglyated formulation with a longer half-life
