Gout

What is gout

What is gout

Characterized by pain and inflammation in joints

Excessive uric acid

Stages of gout

1)Asymptomatic hyperuricemia

2)Acute gout

3)Intercritical phase

4)Chronic gout

How to treat stage 2 acute gout

NSAIDs

Colchicine

Glucocorticoids

Oxaprozin

How to treat chronic gout

Allopurinol

Febuxostat

Probenecid

Pegloticase

Colcohine

Binds tubulin, prevents microtubule polymerization

-inhibits cell dividion

Narrow therapeutic index

Reduce inflammation primarily by inhibiting leukocyte migration and decreasing phagocytosis.

CYP3A4 inhibitors actually increase plasma levels of colchicine

GI side effects

Interactions: Tacrolimus, Cyclosporine, Verapamil

Xanthine oxidase inhibitors to lowe rurate levels

Allopurinol, Febuxostat

Drug interactions: Azathioprine, 6 mercap

Allopurinol increase levels of hypoxanthine and xanthine in the

body

Uricosuric agents to increase excretion

Probenecid

Losartan

Recombinant uricase for breakdown drugs

Pegloticase- gout flare

Rasburicase- tumor lysis syndrome

dont use in G6PD

Pegloticase

Rasburicase