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21 Cards in this Set

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