Week 8: Gout / Uric Acid, Muscle relaxants

Question 1

ACUTE: Miscellaneous/Anti-Gout Drug?

Answer 1

Colchicine

Question 2

CHRONIC/ URATE LOWERING THERAPY (ULT):

Drugs that decrease Uric Acid
Productions?

Answer 2

Allopurinol
Febuxostat (not used because of death warning)

Question 3

Colchicine

Used for?

Answer 3

Used for acute gout flare ups (loading dose followed by maintenance)

Gout prophylaxis during initiation of urate-lowering therapy (maintenance dosing)

Question 4

Colchicine

Adverse effects

How to take?
Avoid what?
What can it cause? two

Answer 4

TAKE ON EMPTY STOMACH
(take w food if GI symptoms)

AVOID GRAPEFRUIT JUICE!!!!

MYELOSUPPRESSION!!!!

Rhabdomyolysis!!!:

Breakdown of muscle tissue that releases a damaging protein into the blood

Question 5

CHRONIC GOUT MANAGEMENT

Drugs that decrease Uric Acid Production

Allopurinol

SCAR?
what test is recommended?
Symptoms?

Answer 5

Severe Cutaneous Adverse Reactions (SCAR)= (SJS) or (TEN)

Recommend that patients of Asian descent and African Descent be tested for HLA-B*58:01

SYMPTOMS:
*Start 48-72 hours later (or longer!)
*Rash (that begins to blister)
*Fever
*Mouth sores
*Lip peeling

Question 6

Allopurinol / Febuxostat

When to take?
Water?
Monitor what?
Contradiction?

Answer 6

After a meal!!!

8-10 glasses of water daily!!!!

Monitor uric acid, hydration. and HEPATOTOXICITY!!!

Not for HLA-B*58:01 positive clients

Question 7

What is Baclofen and Dantrolene used for?

What is Cyclobenzaprine used for?

Answer 7

Baclofen: Spasticity (cerebral palsy, stroke, multiple sclerosis etc)

Cyclobenzaprine: Spasms

think of benzo/cyclobenzaprine (these are part of the B & Z drug list)

Question 8

What is dantrolene used for?

Do not take what with baclofen?

Answer 8

Malignant Hyperthermia

Antihistamines

Question 9

Muscle Relaxants

Adverse effects of Baclofen, Dantrolene, and Cyclobenzaprine

They are like what?
What is expected?
If used chronically?

Answer 9

Think of the drug class name, RELAXANTS!

They are like drinking alcohol

Dizziness/Sedation/Drowsiness/ Fatigue

Can be misused (people can develop dependency and tolerance)

If taken chronically, must taper off!

Part of the B & Z rule!

Can be taken at bedtime to reduce fall risk/drowsiness

Do NOT drive on these!

These also have anticholinergic properties (Dantrolene does not)

Dry Mouth, Constipation are expected