Term
| What NSAIDs are used for the treatment of gout? |
|
Definition
indomethacin
ibuprofen
ketorolac |
|
|
Term
| What drug used to treat gout comes from periwinkles and blocks microtubules which move things into cells? |
|
Definition
|
|
Term
| two types of hyperuricemia |
|
Definition
uric acid overproduction
uric acid underexcretion |
|
|
Term
| What is an important event for developing acute crystal-induced synovivtis? |
|
Definition
|
|
Term
| lab finding for aspiration of gouty joint |
|
Definition
| negatively birefringent crystals |
|
|
Term
| Why might the ESR be elevated during gout attack? |
|
Definition
|
|
Term
| therapeutic goals of pharmacologic treatment of gout |
|
Definition
-terminating attacks
-providing control of pain/inflammation
-preventing future attacks
-preventing complications (renal stones, tophi, destructive arthropathy) |
|
|
Term
| most commonly used treatment for gout |
|
Definition
|
|
Term
| When do you d/c NSAID use for acute gout? |
|
Definition
| pain and inflammation resolved for 48 hours |
|
|
Term
| treatment for acute gout which inhibits microtubule aggregation which disrupts chemotaxis and phagocytosis and inhibits crystal-induced production of chemotactic factors |
|
Definition
|
|
Term
| colchicine adverse effects |
|
Definition
GI discomfort
nausea
cramping |
|
|
Term
| How is colchicine administered? |
|
Definition
oral hourly doses until pain/inflammation have resolved or GI effects prevent further use
also can do IV loading dose, then every 6 hours until max dose reached at 24 hrs |
|
|
Term
| Why should colchicine not be used in CHF patients? |
|
Definition
|
|
Term
| What treatment is used for patients who cannot tolerate NSAIDs or have failed NSAID/colchicine therapy? |
|
Definition
|
|
Term
| What is the corticosteroid used for treatment of gout? |
|
Definition
|
|
Term
| How long does it take to see improvement with prednisone? |
|
Definition
|
|
Term
| ACTH promotes the release of _________. |
|
Definition
|
|
Term
|
Definition
| peripheral anti-inflammatory effects and induction of adrenal glucocorticoid release |
|
|
Term
| What type of patients are intra-articular steroid injections beneficial for? |
|
Definition
-1-2 large joints affected
-elderly with renal disease, PUD, etc. |
|
|
Term
| What drugs are used for intra-articular steroid injections in the treatment of gout? |
|
Definition
triamcinolone
dexamethasone
(with or without lidocaine) |
|
|
Term
| non-pharmacologic treatments of gout |
|
Definition
-immobilization of joint
-ice pack
-abstinence of alcohol
-dietary modification! |
|
|
Term
| What drugs contribute to hyperuricemia? |
|
Definition
-thiazide and loop diuretics
-low dose salicylates
-niacin
-cyclosporine
-ethambutol |
|
|
Term
| What drugs can be used as gout prophylaxis? |
|
Definition
losartan
colchicine
allopurinol
probenecid (sulfinpyrazone) |
|
|
Term
| losartan mechanism of action in preventing gout |
|
Definition
| promotes urate diuresis and may even normalize urate levels |
|
|
Term
| What prophylactic medication is useful in elderly patients with HTN and gout? |
|
Definition
|
|
Term
| Why is colchicine usually used in combination with a urate lowering drug in gout prevention? |
|
Definition
| prophylaxis without urate lowering drug may allow tophi to develop |
|
|
Term
| What are the urate lowering drugs? |
|
Definition
allopurinol
probenecid (sulfinpyrazone) |
|
|
Term
| What drugs are used for urate overproducers? |
|
Definition
allopurinol
probenecid (sulfinpyrazone) |
|
|
Term
|
Definition
|
|
Term
| What can happen when starting a urate lowering drug? |
|
Definition
| acute gout attack (may need to use colchicine as long as 6 months) |
|
|
Term
| What drug is a xanthine oxidase inhibitor? |
|
Definition
|
|
Term
| What drug is a uricosuric drug? |
|
Definition
| probenecid (sulfinpyrazone) |
|
|
Term
| allopurinol mechanism of action |
|
Definition
| blockers conversion of xanthine to uric acid |
|
|
Term
| Which urate lowering drug acts for both overproducers and underexcretors? |
|
Definition
|
|
Term
| probenecid (sulfinpyrazone) mechanism of action |
|
Definition
| increases renal clearance of uric acid by inhibiting tubular absorption |
|
|
Term
| probenecid (sulfinpyrazone) side effects |
|
Definition
|
|
Term
| What do you need to get in a patient starting on probenecid? |
|
Definition
|
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