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21 Cards in this Set
- Front
- Back
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Hyperuricemia
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Uric acid level >6,8mg/dl
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Drugs that causes gout
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Thiazide diuretics, low dose aspirin(<1gm/day), cyclosporine
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Factors associated with gout
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Insulin resistance, metabolic syndrome, CHF, organ transplantation
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Dietary factors associated with an increase of gout
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Beer, wine, soft drinks, fructose, increased dietary purines (meat, seafood)
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Dietary factors that decrease gout
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coffee, dairy products, vitamin C
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Clinical characteristic of acute gout
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Rapid onset of joint pain, redness and swelling of the joint (esp 1st MTP)
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DDX of acute gout
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Septic arthritis, other crystal arthritides (eg Calcium pyrophosphate)
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Treatment of acute gout
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NSAIDS, colchicine, glucocorticoids, corticotropin
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Dose of colchicine
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1.2mg at first sign of an attack then 0.6mg 1 hr later. then 0.6mg bid
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Dose of Naproxen
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500mg bid for 5 days
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Dose of indomethacin
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50mg tid for 2 days then 25mg tid
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Dose of prednisolone
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30-35mg daily for 5 days
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When to start urate lowering therapy
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2-4 weeks after resolution of an attack
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Goal of therapy
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Uric acid <6mg/dl
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Classes of drugs used to lower uric acid
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xanthine oxidase inhibitors, uricosuric and uricase agents
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Xanthine oxidase inhibitors
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Allopurinol 300mg daily
Febuxostat 80mg/day |
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Uricosiric drugs
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Probenecid, sulfinpyrazone, benzbromarone
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Uricase (pegloticase)
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Used intravenously
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Uricase
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converts uric acid to allantoin which is more soluble
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xanthine oxidase inhibitor
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decrease formation of uric acid
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uricosurics
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blocks renal tubular reabsorption of urate
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