Term
|
Definition
| NSAID: 25-50mg TID immediate release, 75mg BID sustained release cap, 50mg suppository |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| if >36 hours after start of attack |
|
Definition
| favor NSAID over colchicine |
|
|
Term
| Indomethacin possible MOA favorability |
|
Definition
| potentiates the activity of vasopressin which promotes water reabsorption in the distal nephron preventing diuresis |
|
|
Term
|
Definition
| most benificial in the first 24 hours, and stay inside 36 hr window from the initial attack |
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|
Term
|
Definition
| two 0.6mg tablets, then take one tablet an hour later if side effects are not unbearable and the attack symptoms are still present |
|
|
Term
| side effects of colchicine |
|
Definition
| nausea/ vomiting, diarrhea (most ppl experience before relief of attack, neutrapenia, axonal neuromypathy |
|
|
Term
| interactions with colchicine |
|
Definition
| clarithromycin (macrolides) reduce billiary excretion leading to increased plasma levels and agranulocytosis |
|
|
Term
| erythromycin + colchicine |
|
Definition
| most likely to interact – potent inhibitor of both 3A4 and P-glycoprotien |
|
|
Term
| azithromycin + colchicine |
|
Definition
| Azithromycin – least likely to interact |
|
|
Term
|
Definition
| antimitotic, prevents vesicles in phagocytes from moving alone the microtubule tracts, no analgesic properties but is also and anti-inflammatory |
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|
Term
|
Definition
| dilute 2 mg in 10-20ml of NS and administer over 20minutes. Follow with two 1 mg doses at 6 hour intervals. (max 4 mg in 24 hours) Then no colchine by any route for 7 days. |
|
|
Term
| IV therapy associated adverse reactions of colchicine |
|
Definition
| bone marrow suppression, tissue necrosis, coagulation, hepatocellular toxicity and renal failure |
|
|
Term
|
Definition
| when NSAIDs or Colchicine are ineffective, not tolerated or contraindicated |
|
|
Term
|
Definition
| 30-60mg daily for 3-5 days. Taper dose over 10-14 days (decrease by 5mg daily) to prevent rebound attacks |
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|
Term
|
Definition
| purine analog, acts first as a substrate and then as an inhibitor of xanthine oxidase; suicide inhibition |
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|
Term
| allopurinol + CrCl 10-20 mL/min |
|
Definition
|
|
Term
| allopurinol + CrCl <10 mL/min |
|
Definition
|
|
Term
| allopurinol + CrCl <3 mL/min |
|
Definition
|
|
Term
|
Definition
| rash,Stevens-Johnson, hepatitis, interstitial nephritis, eosinophilia |
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|
Term
|
Definition
|
|
Term
| allopurinol hypersensitivity syndrome |
|
Definition
| gout pts get the rash – can be FATAL; dose related; Follow desensitizing protocol on pg 1547 of text book |
|
|
Term
|
Definition
| xanthine oxidase inhibitor, indicated for chronic management of hyperuricemia and NOT for asymptomatic hyperuricemia |
|
|
Term
|
Definition
|
|
Term
|
Definition
| allopurinol is ineffective, not tolerated or possibly in the case of renal impairment where allopurinol dose adjustment is below therapeutic range |
|
|
Term
| uloric is not a purine analog |
|
Definition
| not expected to inhibit other enzymes involved in purine synthesis and metabolism |
|
|
Term
|
Definition
| filtered at the glomerulus and then secreted in the proximal tubule and reabsorbed in the distal tubule interfering with the kidney’s ability to reclaim uric acid from the urine. More uric acid leaves the body in the urine, lowering the uric acid concentration in the plasma.5 |
|
|
Term
| do NOT give to those who are overexcreters (max 2 grams) |
|
Definition
| Probenacid; higher incidence of stone formation |
|
|
Term
|
Definition
| rash, GI upset, and stone formation |
|
|
Term
| interactions with probenacid |
|
Definition
| salicylates, can cause treatment failure |
|
|
Term
| probenacid can cause secretion inhibition in kidney of |
|
Definition
| penicillin, tamiflu, cephalosporin, methotrexate |
|
|
Term
| probenacid + CrCl <50 mL/min |
|
Definition
|
|
Term
| Sulfinpyrazone (Anturane®) |
|
Definition
| acts as an anti-platelet drug - not available on the market since at least Sept 2011 |
|
|
Term
|
Definition
| not available on the market since at least Sept 2011 |
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