Term
gout result of metabolism of |
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gout diseasei sm ot commonly dueto |
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Definition
lack of clearance , (as opposed to overproduciton) |
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inhibits tuublin polyermization into microttubules, , inhibitsl uekocyte miraiton nad phagocytosis |
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colchicine method of takign |
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Definition
oral. used for acute attacks |
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Definition
lots (not mentioned: nause vomitting abdmoinal pain, burning throat patin , blodo idarrhea, shock hematuria, and oliuria).
no logner first lien agnets due to toxicities. |
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used for acute gout, msot popular nsaid. |
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Definition
inhbits cox mediated PG syntehsis |
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Definition
nsaid that also icnerases uric acid excreiton in urine |
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oxaprozin adverse effects |
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Definition
will make kdiney stones worst if you dont be careful |
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increase sectiona nd decerase reabsortion of uric acid (organic acids haat act at the anion tranprot sites of proximal tubules |
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Term
uricosuric agetns advantags |
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Definition
in tophagcoues depsotis iwl lstimualte rebosrption of the tophi. |
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Term
uricosuric agents interactions |
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Definition
aspirin- inhibits secretory urate transporter |
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Term
uricosuric agnets indications |
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Definition
for CHronic NOT acute. expectation tobe taken for a long period. used in aptients iwth frequent attacks, patients with tophaceous gouts- excellent for this, but useful only for udnerexcretors. |
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Term
uricosuric agents adverseeffects |
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Definition
dont use in patients who over excrete or even excrete nromal elvels of urate, otherwise will predispose to uric acid stones. NEed to keep ph alkaline and urinate frequently.
no basis for choosing on drug over antoehr. Irritating to gut. Take with food and divided dose |
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Definition
irreversible antagonist of xanthien oxidase (purine analog) |
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Definition
irreversible antagonist of xanthien oxidase (nonpurine) |
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Term
xanthine oxidase inbhitior |
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Definition
intercrises agent, the preffered agent for chronic gout therapy. Chronic tohgacous gout (can dissovle tophi more rapidly than uricosurics). These will cork with renal stoen aptients. also useful for patients with renal impairement.
taken for years and life. |
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Term
aloppurinol blocker adverse effects |
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Definition
acute gouty attacks due to intial flare occuring when urate crystals are beign withdran form tissues. Initaited with colchicine or an nsaid (indomeathicn , until steady state seru mruaret e is nromalized to lese than 6 mg/dl. Gi irriation, take with foodas |
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Term
allopurinol specific s9de effects |
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Definition
allopurinol is less preferred to febuxostat due to unique adverse effects.
necrotizing vasculitis, aplastic anemia, hepatic toxicity, itnerstial neprhitis. rarely cataracts.
MSOT COMMON: ALLERGIC SKIN REACTIONS: toxic epidermal necrolysis. - STevens johnsons syndrome.
Drug itneractions: ltos of drus inlucindg mercapturopine, warfarin. |
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Term
febuxsostat vs. allopurinol |
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Definition
febuxostat much better tolerated in patients with allpuoruinol intoelrance. |
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Definition
inhibits cox IRREVERSIBLY. platelet is inactivated for hte lifetime of the platelet. |
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Term
cox 1 vs. cox 2 in thrombosis |
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Definition
cox 1 is foudn in paltelets , inhibit cox-1 and formaiton of thormobxan a 2 and thrombosis.
this shifts balance to cox-2 in endothelium. Cox 2 in endothelium leads to prostacyclin produciton which reduces thrombosis. |
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Term
cox 2 inbhiitors problems |
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Definition
you inhibit, cox2= upregulatio nfo cox1 leadign to thormbosis |
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Term
pharm properties of nsaids |
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Definition
antiinflammtory=- mediated primarily through cox-2 inhibition of prostaglandin biosyntehsis.
Anaglesic activity- mediated thorugh inhibition of prostaglandin biosyntehsis centrally and locally.
antipyrertic activity- prverntion of pge2 syntehsis.
prolongation fo bleeding time- inbhition fo cox-1 i npaltelets = decrsaed txa2 |
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Term
naproxen/ibuprofen vs aspirin |
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Definition
iburporfen has logenr halflives |
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Definition
dhfr inhbitior. inhibting producers of dna syntehsis, reducing inflammatory cells |
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methotrexate adverse effects |
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Definition
foalte deficiency, folic acid supplemeantion, contraindicatedi n rpegnancy |
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Definition
rhumeatoid arhtiritis as wel las other inflammatory disorders |
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pyrimidien syntehsis inbhitiors |
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leflunomide pharamcokientics |
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Definition
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leflunomide adverse effects |
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Definition
teratogenic, stop 2 yeears prior pregnancy |
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hydroxycloroquine adverse effects |
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Definition
requries 3-6 months for benefit, may due retinal damage |
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usefulf or RA but litmited use logn term due to toxicity. |
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Term
etanrecept moa and mode of adminsitration |
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Definition
protein so has to be adminsitered IV. Binds to TNF alpha with high affinity. (it is a receptor nto an antibody) |
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Definition
synergistic with methotrexate |
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Definition
antibody to tnfalpha. reduces blodo elvel of tnfalpha. |
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Definition
fully human antibody to tf as opposed to inflixmab, decreawsed immuen resposne of host. |
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Term
glucorticoicds vs. nsaids |
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Definition
glucocorticoids inhibit formation fo aarachidonate from phospholipids, (vi inhibtion o PLA2).
NSAIDs= inhibition of formaiton of arachidonate to prostaglandin vis inhibition of cox |
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