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19 Cards in this Set
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Uricosuric agents such as probenecid lower uric acid levels in the body by increasing the elimination of uric acid. These agents are not useful in many patients with gout since they require adequate: |
Renal function Uricosuric agents such as probenecid lower uric acid levels in the body by increasing the elimination of uric acid. These agents are not useful in many patients with gout since they require adequate renal function. |
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Which of the following are risk factors for the development of gout? (Select ALL that apply.) |
Risk factors include male sex, being overweight, excessive alcohol consumption (particularly beer), hypertension, renal insufficiency, advanced age and using medications that increase uric acid. |
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John Deer is a 54 year-old male with hypertension and renal insufficiency. He presents to the clinic with severe pain and a very swollen big toe. Mr. Deer is diagnosed with gout, and given a prescription for prednisone. Which lab value is likely to be high in this patient? |
Uric acid Gout is caused by elevated uric acid in the joints. The uric acid crystallizes causing a very painful presentation. A painful, swollen big toe, or metatarsophalangeal joint, is a typical presentation for acute gout. |
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A pharmacist is going to counsel a patient beginning allopurinol therapy. Which counseling statement should be included? |
If the patient notices a rash, contact a physician at once. If the rash looks serious, the patient should not use the medicine and should be seen right away. Hypersensitivity reactions, including severe rash (SJ/S/TEN) can occur with allopurinol. |
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A patient is going to use a medication to reduce the incidence of future gout attacks. Which agent/s could be selected for gout prophylaxis? (Select ALL that apply.) |
Allopurinol Probenecid Febuxostat Allopurinol and febuxostat are considered first-line agents for gout prophylaxis. Probenecid is an alternative option for underexcreters. |
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A patient is having an acute gout attack. As an alternative to colchicine, which of the following treatment options can be recommended to help treat the acute pain and inflammation? (Select ALL that apply.) |
Naproxen Prednisone Ibuprofen Allopurinol and febuxostat are not used for acute gout treatment; it is used for prophylaxis (or prevention) of future gout attacks. |
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Which of the following medications can elevate uric acid? (Select ALL that apply.) |
Niacin Thiazide diuretics Loop diuretics Cyclosporine Tacrolimus Loop and thiazide diuretics, niacin, high-dose aspirin, pyrazinamide, cyclosporine, and tacrolimus are the medications with the highest know risk to increase uric acid. |
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A patient gave the pharmacist a prescription for Zyloprim 100 mg daily. Which of the following is an appropriate generic substitution for Zyloprim? |
Allopurinol |
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A patient has been given a prescription for colchicine 0.6 mg #12. Choose the correct dosing regimen for colchicine: |
1.2 mg orally followed by 0.6 mg in 1 hour (not exceed a total of 1.8 mg - or 3 doses) Colchicine (Colcrys) is taken at the first sign of an acute flare. Instructions are to take two of the 0.6 mg tablets. Another tablet can be taken in one hour. Three tablets, or 1.8 mg total dose, is the maximum per treatment. If the patient gets GI side effects after the initial dose they should not use the third tablet. |
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The use of probenecid can block renal clearance of some of the drugs that are cleared by the kidneys. Which of the following agents may have decreased clearance if taken in a patient using probenecid? (Select ALL that apply.) |
Aspirin Ampicillin Methotrexate Amoxicillin |
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Which of the following risk factors can increase a person's risk of gout? |
Consuming beer Being overweight Having hypertension |
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What is the mechanism of action of allopurinol? |
Xanthine oxidase inhibitor |
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Which of the following are true regarding pegloticase? (Select ALL that apply.) |
It should be reserved for refractory cases. Anaphylactic reactions can occur during infusion. The brand name is Krystexxa. |
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What is the rationale in using colchicine or an NSAID while beginning allopurinol therapy? |
To reduce the risk of an acute flare |
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A patient with gout begins allopurinol 100 mg daily. The patient should be instructed to watch for this adverse effect, and to be seen promptly if it appears serious: |
Rash |
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Which of the following dietary recommendations are thought to reduce the risk of future gout attacks? (Select ALL that apply.) |
Consuming low fat dairy products. Reducing intake of beef, lamb and pork. Avoiding intake of organ meats, such as chopped liver. Avoiding intake of high-fructose corn syrup. |
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Which side effects occur in most patients from the use of colchicine? |
Nausea, vomiting, diarrhea, abdominal pain |
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John Deer is a 54 year-old male with hypertension and renal insufficiency. He presents to the clinic with severe pain and a very swollen big toe. Mr. Deer is diagnosed with gout, and given a ten-day prescription for prednisone. Which of the following are short-term side effects from the use of prednisone? (Select ALL that apply.) |
Possible blood sugar elevation Feeling "spacey" or irritable Insomnia |
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Which analgesic should not be recommended to help with the pain of an acute gout attack as it may increase uric acid levels? |
Bufferin |
