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10 Cards in this Set
- Front
- Back
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Hyperuricemia levels for men and women?
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Uric Acid greater >7 in men
>6 in females |
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Short term therapy vs. long term therapy?
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Short-term: relieve symptoms of attack(infrequent flare-ups <3/year)
-NSAID's- First-line agents -Glucocorticoids also used Long-term: lower blood levels of uric acid(3 or more times a year) -Uricosuric Drugs*** |
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First choice agent for Gouty Arthritis?
AE? |
NSAID's
AE- GI ulceration, decreased renal function, fluid restriction, increased risk of cardiovascular events |
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How about another drug used for gouty arthritis that is highly effective in relieving pain and is used for patients who are unable to take NSAID's for any reason?
How is it given? Who shouldn't take it? |
-Glucocorticoids
-PO or IM (prednisone - 20-40 mg's on day 1, then taper down over next 8 days) -Hyperglycemic patients |
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COLCHICINE***
What kind of agent? TU? Dose? AE? |
Anti-inflammatory- (USED to be first-line) Now used for patients who are intolerant to safer meds.
TU-Acute gouty attack, reduces incidents of attack, and ABORTS an impending attack, Dose- for prophylaxis 0.6mg's 1-2x/day. ONLY ORAL AE- GI EFFECTS******** |
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Drug Therapy for Hyperuricemia
What are the 4 meds and what do each do to control uric acid? |
(A father provides safety)
These drugs DO NOT provide analgesic or anti-inflammatory actions - NOT used for acute gouty attack Allopurinol - inhibits uric acid formation Febuxostat - inhibits uric acid formation Probenecid - increases uric acid excretion Sulfinpyrazone - increases uric acid excretion |
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Allopurinol- MOA?
Dose? TU? AE? - special consideration? |
MOA - reduces blood levels of uric acid
Dose- 100mg/day TU- chronic tophaceous gout, hyperuricemia due to CHEMOTHERAPY AE- Hypersensitivity syndrome, GI effects, neurologic effects. Initial therapy can cause acute gouty attack, so administer Cholchicine or low dose NSAID to prevent |
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Febuoxstat
MOA? TU? Dose? AE? |
MOA- reduces blood levels of uric acid
DOSE 40-80mg/day TU- chronic tophaceous gout AE - Liver function abnormalities, nausea, arthralgia, rash |
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Probenecid
MOA? Special Consideration? |
MOA- acts on renal tubules to inhibit reabsorption or uric acid (prevents formation of new tophi and decrease existing)
May exacerbate acute episodes of gout - add indomethacin (NSAID) AE- Mild GI effects, take with food. |
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PEGLOTICASE- used for who? (8mg infused over 2 hrs)
AE Special Cons.? |
Use- IV therapy for patients w/ chronic gout who haven't responded to oral meds. (LAST RESORT)
AE - Initial Gout Flare -Anaphylaxis (6% of all pt's) -INFUSION REACTIONS - (26-41% of all pt's) Special - premedicate with antihistamine and glucocorticoid. |
