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21 Cards in this Set
- Front
- Back
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Gout
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recurrent acute attacks of urate crystal-induced arthritis
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Tophi
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deposits of monosodium urate in and around joints and cartilage and in the kidneys
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Tx of acute gout
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1. NSAIDS
2. Colchicine 3. Steriods |
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NSAIDs
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1. indomethacin
2. naproxen 3. sulindac |
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COLCHICINE
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suppress inflammation: alkaloid from C. autumnale
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Colchicine MOA:
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inhibits of tubulin polymerization prevents leukocyte migration and phagocytosis.
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Peak levels of colchicine
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orally in 2 hours
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MAJOR A.E. colchicine:
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1. GI TOXICITY: (large amount of the drug and metabolites enter the bile and intestinal secretions)
2. Inhibit mitosis failure of spindle of formation |
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Acute poisoning with colchicine:
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1. hemorrhagic gastroenteritis
2. Vascular damage 3. Nephrotoxicity 4. Muscular depression 5. Paralysis of CNS |
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Colchicine NOT used in:
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1. pregnancy
2. caution w/ hepatic, renal, GI, or CV disease, elderly pt. |
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Colchicine in:
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prophylactic use:
- pt w/ chronic use - small of an oral dose 0.5 mg/QD or QOD. |
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STEROIDS: decrease inflammation
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Prednisone or Methylpredisone.
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Uricosuric Agent:
A drug that increases the rate of excretion of uric acid. |
Probenecid (BENEMID)
Sulfinpyrazone (ANTURANE) |
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Pharmacokinetics of Uricosuric:
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SIGN. bound to albumin
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A.E. OF URICOSURICS
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liberal fluid intake should be maintained because of the tendency to produce stones
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When administerating URICOSURICS watch out for an acute gout attack, adm with?
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- colchicine or NSAIDs
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Precautions with Uricosuric when given with what disease or drug?
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1. ASA interferes with uric acid secretion.
2. Should not be used in pts w/ nephrlithiasis. 3. Uricosurics reduce effectiveness of nitrofurantoin. |
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Xanthine Oxidase Inhibitor:
ALLOPURINOL (ZYLOPRIM) |
active metabolite: oxypurinol
INHIBITION OF THE ENZYME ACCOUNTS FOR THE MAJOR PHARMACOLOGICAL EFECTS |
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DRUG INTERACTIONS OF allopurinol
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Increase in:
1. azathioprine: immunosup 2. 6-mecaptopurine: antic |
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CAUTION WHAT CAN ALLOPURINOL PRECIPITATE
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ACUTE GOUT
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MOST COMMON A.E. of allopurinol:
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rash (ampicillin increase rash to 20%)
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