Gout

definition

recurrent inflammatory disorder of one or more joints

-characterized by URATE CRYSTALS in joint fluid

(occasional hyperuricema)

caused by excessive uric acid or renal impairment 

drug classes used to 

treat Gout

-NSAIDs (naproxen)

-glucocorticoids (pain and inflammation)

-colchicine (acute attack)

-allopurinol (dec uric acid pdtn)

-febuxostat 

-uricosurics (inc uric acid excretion) 

Gout Rx

colchicine

mechanism

and 

indication

anti inflammatory agent

uses:

acute gouty attack- large enough ORAL dose till causes GI s/e

prevention- low daily doses

Gout Rx

colchicine

ADRs

GI: used to titrate doses

nephrotoxicity

Gout Rx

allopurinol

decreased pdtn of uric acid: inhibition of enzyme that metabolizes precursors (xanthine oxidase inhibitor)

Uses: chronic gout and hyperuricemia in chemo

ORAL daily

ADR's: well tolerated

-hypersensitivity

Gout Rx

febuxostat

xanthine oxidase inhibitor: prevents enzyme that metabolizes uric acid

-advantages: may cause less s/e dt lack of titration method

---- high cost

Gout Rx

Uricosurics

drug names

probenecid

sulfinpyrazone

both uricosurics (increase urinary excretion of UA)

both ORAL and neither for long term use or acute

probenecid= DOC

ADR's 

GI: common

kidney stones (nephrolithiasis)