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28 Cards in this Set
- Front
- Back
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Gout consists of a serum urate of >________mg/dL
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7.0-7.5
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List some risk factors for Gout.
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Uric Acid
Age Male SrCr/BUN BP weight Alcohol Intake |
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what is the normal production of urate?
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600-800mg/day
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What are the two ways uric acid is eliminated?
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Urine
GIT (Enzymatic degradation by colonic bacteria) |
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Untreated attacks could last _____ days before spontaneous recovery
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3-14
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How would you treat an acute gouty attack?
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NSAIDS at max dose until 24 hrs after resolution of attack.. then taper down over 2-3 days
if NSAIDS contraindicated use steroids If Both contraindicated give colchicine only if symptom onset ,48 hrs |
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what is the AE of Colchicine
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GI Side effects
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This NSAID is as effective as Colchicine and is given at 75mg initially followed by 50mg Q6h for 2 days and then 50mg Q8h for 1-2 days
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Indomethacin
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This is used for acute gouty arthritis for resistant cases or when colchicine or NSAIDs are contraindicated
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Corticosteroids
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Which Corticosteroid do you use in single joint acute gouty attack?
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Triamcinolone 20-40 mg once Intra Articularly
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This corticosteroid is given in acute gouty attacks with Multiple joint involvment
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Prednisone 30-60mg PO for 3-5 days
taper dose over 10-14 days to avoid rebound attacks |
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This is the last line for an acute Gouty attack
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Colchicine 1mg PO initially then 0.6mg q2h
begin therapy within 24-48 hours of symptoms |
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What is the goal serum urate level for pts treated for gout Prophylactically
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6mg/dl
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My serum urate is 8md/dl. should I be treated prophylactically?
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no
>10 can be treated prophylacticlly |
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What are 3 options for PT for gout?
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Low dose NSAIDS (with PPI)
Low dose Colchicine UALAs (Uric acid Lowering agent) |
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How many gouty attacks per year would qualify you for Prophylactic Therapy?
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>2attacks/year
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Avoid Chronic use of colchicine is CrCL <_____ml/min
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50
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what is the maintenance dose of colchicine as prophylactic therapy
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0.6-1.2mg BID
If sence acute attack increase dose to 1mg q2h |
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T/F Continue Colchicine Therapy is SR urate is normal and pt is symptom free for 1 year
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FALSE
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Name two Uricosurics
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Probenecid
Sulfinpyrazone |
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This is a Xanthene Oxidase Inhibitor
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Allopurinol
Uloric(Febuxostat) |
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These can be used as an alternative to Allopurinol on pts <60 yo with Normal renal fxn and no hx of kidney stones
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Probenecid
Sulfinpyrazone |
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This MOA is to decrease renal tubular reabsorption of uric acid
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Uricosuric agents:
Probenecid Sulfinpyrazone |
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What is a Contraindication for uricosuric agents such as Probenecid or sulfinpyrazone?
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CrCl<50mL/min
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this is the DOC for Gout.
What is its dose? |
Allopurinol
300mg/day |
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I suffer from gout and have a hx of Kidney stones. what would u recommend?
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allopurinol
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SE of allopurinol
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Skin Rash
Leukopenia GI |
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Febuxostat Dosage
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40mg/day
increase to 80mg/day if serum uric acid level is not < 6 mg/dL after 2 weeks |
