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15 Cards in this Set
- Front
- Back
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gout typically occurs where |
in 1 joint, the metatarsophalangeal joint, the big toe
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risk factors for gout
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male
overweight (2-3 x increases risk) overdrinking beer HTN renal insuff |
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if pt case on the exam shows an asymptomatic pt with high uric acid levels >7
what med is 1st line? |
asymptomatic hyperuricemia is NOT treated
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meds with highest known risk of increasing Uric Acid
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thiazides and loops
Niacin Aspirin Pyrazinamide |
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colchicine for Acute Gout Attack
brand dosing |
colcrys
1.2 mg and a 0.6mg dose 1 H later(comes as 0.6 mg) NO more than 1.8mg |
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NSAIDs used for Acute Gout
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Indomethacin, naproxen, sulindac, Celebrex
caution avoid use in renal insuff patients- most gout ptients have renal insuff |
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steroids to tx gout can be given how....
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PO, IM, IV, intra-articular and via ACTH-triggers endogenous glucocorticoid secretion
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meds to tx acute gout
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colchicine, NSAIDs, and steroids
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colchicine counseling
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take 2 tabs and can take 1 more 1 h later
do not take more=serious SE wait 3 days before starting around round of tx |
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prophylactic tx
when beginning UA lowering acid, what med should be started and whats dose |
colchicine 0.6mg Daily or BID for 6 months
or NSAIDs |
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Allopurinol for gout prophylaxis
brand? MOA use? |
zyloprim
Xanthine Oxidase inhibitors-block UA production used for UA prophylaxis risk of hypersensitivity rxn |
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febuxostat
brand? MOA SE use |
Uloric
MOA-Xanthine oxidase inhibitors SE-less chances of hypersensitivity rx, safer in sever renal disease more expensive than allopurinol use- UA Prophylaxis |
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uricosuric meds for gout prophylaxis
class CI |
probenacid, colchicine+probenacid combo, sulfinpyrazone
all require adequate renal fxn |
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uricase meds for Gout propylaxis
MOA when to use |
pegloticase (Krystexxa)
breaks down uric acid IV med, very exp, used in resistant cases only |
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allopurinol counseling
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take with food
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