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27 Cards in this Set
- Front
- Back
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what is the progression of disease of gout?
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monoarticular attacks
to polyarticular attacks to monosodium urate tophi= severe pain |
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What two mechanisms cause high uric acid to occur?
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over production
under excretion |
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What are the two treatment goals in gout tx?
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terminate inflammatory processes
reduce high uric acid levels |
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What conditions may cause overproduction of uric acid?
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polycythemia vera
myeloid metaplasia leukemia/lymphoma |
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what condictions may cause underexcretion of uric acid?
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lead neruopathy
glycogen storage disease sickle cell |
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What kind of drug is Colchicine?
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this is an anti-inflammatory agent, effective only against gout
provides dramatic relief |
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What are the effects of Colchicine?
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NO analgesia!
inhibits microtubule assembly inhibits leukocyte migration and phagocytosis |
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How is colchicine given?
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oral admin, effective in 12-24 hours
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What are the common side effects of colchicine?
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diarrhea, nausea, vomiting
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what is the primary NSAID used for gout tx?
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indomethacin
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What NSAIDs should NOT be given with gout?
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aspirin, salicylates- these decrease uric acid excretion
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Where in the kidney do uricosuirc agents act?
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these block uric acid active reabsorption in the proximal tubule
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What two things need to also be done when administering a uricosuric agent?
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high fluid lintake to prevent stone formation
cholchine to prevent attacks |
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What kind of drug is Probenecid?
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this is a uricosuric agent
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How long after a gout attack do you need to wait to give probenecid?
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about 2-3 weeks
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What else does probenecid decrease the excretion of?
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penicillin, methotrexate, clofibrate
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What kind of drug is sulfinpyrazone?
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this is uricosuric agent
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what are the side effects of sulfinpyrazone?
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inhibits platelet aggregation
inhibits warfarin metabolism |
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What kind of drug is Allopurinol?
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this inhibits the synthesis of uric acid
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what enzyme does Allopurinol affect?
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this inhibits xanthine oxidase
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what are the serious side effects of Allopurinol?
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this can cause vasculitis, agraunlocytosis, and hypersensitivity reactions
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What might be needed when starting a Allopurinol regimine?
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colchicine prophylaxis
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What kind of drug is Rasburicase?
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this turns uric acid into allantoin, which is easily excreted by the kidneys
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How effective is Rasburicase?
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extremely effective, 99-100%
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How is Rasburicase given?
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IV
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What are the risks of Rasburicase?
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serious hypersensitivity reactio ns
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Who is given Rasburicase?
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people at risk for tumor lysis syndrome- which can cause very high uric acid levels in the blood
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