Wk 17: Gout therapeutics

Question 1

How is purine metabolised?

Answer 1

• Adenine deamination
• Ribose 5 P removal
• Converted to xanthine
• Converted to uric acid

Question 2

Outline the gout pathogenesis

Answer 2

Monosodium urate crystals deposit in cartilage in joint space

Question 3

Outline the cause of hyperuricemia

Answer 3

Over production of uric acid:
- Excessive cell destruction

• High purine intake

Red renal excretion:
- Renal failure

• Diuretics

Question 4

Colchicine + NSAID mechanism of action in gout

Answer 4

• PMN release inflammatory leukotrienes that attract inflammatory cells
• Colchicine act on microtubules in inflammatory cells
• NSAIDs act on COXII in joints

Question 5

Allopurinol MOA

Answer 5

• Red uric acid conc in tissue
• Inc xanthines + hypoxanthines
• Deposition of urate crystals in tissue reversed