Week 12 - Gout Medications

Question 1

Gout is caused by an excess of __________ depositing in joints

Answer 1

uric acid

Question 2

All of the antigout medications require _______ monitoring

Answer 2

serum uric acid level

Question 3

Which antigout medication is classified as a urocosuric?

Answer 3

Probenecid

Question 4

What is the MOA of probenecid?

Answer 4

Increases rate of uric acid secretion by inhibiting tubular resorption

Question 5

Probenecid is _______ (safe/not safe) for use during pregnancy

Answer 5

safe

Question 6

Probenecid is most useful in treating _________ caused by ___________

Answer 6

• gout
• chronically reduced uric acid secretion

Question 7

True or false:

Probenecid exhibits anti-inflammatory properties

Answer 7

false

Question 8

What attribute of probenecid gives it risk for allergic reactions?

Answer 8

It is a sulfa drug

Question 9

Kidney stones are a potential ADR of probenecid - how can this be combatted?

Answer 9

Decrease the pH of the urine
* Increase fluid intake, use medications that lower pH

urates tend to crystallize in acidic urine

Question 10

Probenecid and Colchicine share common the ADR of _________ and are contraindicated in patients with _________

Answer 10

• GI upset (Nausea/vomitting/diarrhea/pain)
• Peptic Ulcers or other GI disorders

Question 11

Probenecid inhibits the tubular secretion of what drugs

Answer 11

• Penicillins
• Cephalosporins

increases plasma levels - could be useful?

Question 12

Allopurinol and Febuxostat belong to the ________ medication class and are used to treat _________

Answer 12

• Xanthine Oxidase Inhibitors
• Gout

Question 13

How do the xanthine oxidase inhibitors treat gout?

Answer 13

Inhibit the enzyme xanthine oxidase that is responsible for the conversion of xanthine into uric acid
* decreased uric acid production

Question 14

The xanthine oxidase inhibitors require ___________ or more before the full effects can be seen

Answer 14

one week

Question 15

Xanthine oxidase inhibitors are contraindicated in ________

Answer 15

• nursing mothers
• patients with renal or liver dysfunction

Question 16

Xanthine oxidase inhibitors interact with drugs that require __________

Answer 16

xanthine oxidase for metabolism

Question 17

Allopurinol has been safely used at escalating doses even in patients with a history of ______

Answer 17

chronic kidney disease

Question 18

The xanthine oxidase inhibitors may initially cause _______

Answer 18

worsening gout attacks

subsides with time

Question 19

What education should be provided to patients that develop a rash while using allopurinol?

Answer 19

Stop the drug immediately - skin reactions may be severe or fatal

Question 20

Colchicine is a medication used for acute ______

Answer 20

gout attacks

Question 21

What is the mechanism of action of Colchicine?

Answer 21

Decreases inflammatory response to deposited uric acid crystals

Question 22

Although colchicine has very few drug interactions, its use is often limited by ________

Answer 22

side effect severity

Question 23

What are the ADRs associated with colchicine?

Answer 23

• GI upset
• Myopathy, neuropathy
• decreased absorption of B12

Question 24

Colchicine is contraindicated for use in _________ due to risk of ___________

Answer 24

pregnancy
fetal