treatment of gout and rheumatoid arthritis

Question 1

what is gout

Answer 1

hyperuricemia: increased amounts of uric acid

Question 2

hyperuricemia risk factors

Answer 2

• high purine diet
• alcohol
• high fructose drinks

Question 3

antigout agents

Answer 3

• allopurinol: NSAID used to prevent attacks (prophylactic), reduces production of uric acid - xanthine oxidase inhibitor
• colchicine: used for acute attacks, reduces inflammatory response to the deposits of urate crystals
• probenecid, sulfinpyrazone: increase excretion of uric acid in urine

Question 4

rheumatoid arthritis

Answer 4

systematic disease across lifespan

autoimmune and inflammatory disorder
- attack synovium
- joint swelling, pain
- eventual fusing of bones

Question 5

anti rheumatoid arthritis medications

Answer 5

DMARDS: disease modifying antirheumatic drugs
- decrease pain and inflammation
- reduce or prevent joint damage and bone erosion
- slow speed and spread of disease
- preserve joint function
- can be used in other inflammatory conditions
- traditional or biological

Question 6

traditional DMARDs

Answer 6

methotrexate: alone or in combination with other drugs
- cancer chemotherapy in larger doses
- decreased activity of immune system

Question 7

biological DMARDs

Answer 7

• protein drugs against inflammatory mediators (infliximab, adalimumab - antibodies against cytokines)
• etanercept (affects receptor for cytokine)
• protein drugs against immune cell activation: IL-1 inhibitor, L-6 inhibitor, T cell inhibitor, B cell inhibitor, Janus kinase inhibitor

anti inflammatory and immunosuppressive

Question 8

other RA drugs

Answer 8

NSAIDS: symptomatic relief only
glucocorticoids: short term use (immunosuppress)
other immunosuppressant drugs: gold salts