Classify drugs used in gout
- Acute gout
a) NSAIDs
b) Colchicine
c) glucocorticoids - Long-term control of gout or hyperuricaemia
a) Uricosuric agents
b) uric acid synthesis inhibitor’s
Name uricosuric agents for long term gout
- Probenecid
- Sulphinpyrazone
Name uric acid synthesis inhibitor’s
- Allopurinol
- Febuxostat
- Rasburicase
Name NSAIDs used in gout
- Indomethacin
- naproxen
- Diclofenac
- piroxicam
- sulindac
- Etoricoxib
Name glucocorticoids used in gout
- Prednisolone
- methylprednisolone
- triamcinolone
What is the mechanism of action of colchicine
Prevent release of chemotactic factors and inhibits migration of neutrophils
What are the side effects/adverse effects of colchicine
- Nausea, vomiting, diarrhea, abdominal pain
- myopathy
- alopecia
- aplastic anaemia
- agranulocytosis
Explain the drug interaction between probenecid and beta lactam antibiotics
Probenecid competes with penicillin/cephalosporins and block the tubular secretion of Beta lactam. Plasma levels of Beta lactam antibiotics and their duration increases.
What is the mechanism of action of allopurinol
Prevent synthesis of uric acid by inhibiting the enzyme xanthine oxidase thus reducing the plasma levels of urate crystals
What are the adverse effects of allopurinol
Hypersensitivity
1. skin rashes, itching, arrhythmia, headache, fever
2. rarely Steven Johnson syndrome
GIT:
1. nausea, vomiting, diarrhoea
2. hepatotoxicity
What are the contradictions of allopurinol
- Pregnancy
- lactation
- children
- patients with liver and kidney diseases
What are the drug interactions of allopurinol
- Allopurinol X 6- Mercaptopurine: allopurinol inhibits xanthine oxidase and increases effect of drug
What is the mechanism of action of rasburicase
Converts uric acid to soluble allantoin
