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Pharm Exam 3 Study
Guide
Gout Medications
Colchicine – is an anti-inflammatory (gout) = can treat and prevent gout attacks, also Behcets syndrome
• SE = always causes diarrhea, other GI symptoms include upset stomach, nausea, abdominal pain
• Taking with food helps ↓ GI side effects
• Check renal function before and during tx (BUN, creatinine)
• Lower dose (1.2 mg followed by 0.6 mg one hour later) is as effective as high dose but w/ less SE
Allopurinol – xanthine oxidase inhibitor, uric acid reducer, tx gout/prevent flares and kidney stones
• SE = skin rash, flu symptoms, painful or little urination, drowsiness/dizziness
• Monitor renal (BUN, creatinine) and liver function
Febuxostat (Uloric) – xanthine oxidase inhibitor, uric acid reducer for pts with gout/prevent flares
• SE = gout flares, nausea, mild rash, liver problems, heart attack symptoms
• Monitor liver and renal function
• Patient education = gout may worsen with therapy initially (can take NSAID or colchicine for up to
6 months w/ beginning of tx)
Probenecid (Benemid) & Sulfinpyrazone (Anturane) – uric acid reducer, uricosuric agent
• SE = frequent urination, N/V, HA, dizziness, skin rash
• Is NOT an anti-inflammatory, used for CHRONIC gout management
• Watch CBC for blood dycrasias
Corticosteroids – ends in “sone” (prednisone), used to tx RA, lupus, asthma, allergies, etc.
• SE = high BP, weight gain, muscle weakness, insomnia
• Adverse effect of corticosteroids after six months or longer = worry about osteoporosis, can also
worsen diabetic control
• Pt needs vitamin supplements to help prevent osteoporosis, check blood glucose levels
• Report black tarry stools and abdominal pain
• Adrenal suppression w/ long-term therapy (s&s = malaise, myalgia, fever, hyptension) so DO NOT
stop abruptly
• Tapering is necessary to prevent withdrawal symptoms
• If dose of corticosteroid exceeds 1 gram, prescribe a PPI (omeprazole)
Cox-1 Pathway – systemic, present in all tissues, blocking these account for GI adverse rxn
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Cox-2 Pathway – inducible enzyme produced in response to pain and inflammation
NSAIDS (ibuprofen, naproxen, celecoxib, ketorolac) – 1st line for mild to moderate pain, inflammation
• Ibuprofen = non-selective cox-2 inhibitor, decreases prostaglandins, antipyretic, inhibiting cox 1
gives GI side effects
Page 2 of 14
Pharm Exam 3 Study
Guide
Gout Medications
Colchicine – is an anti-inflammatory (gout) = can treat and prevent gout attacks, also Behcets syndrome
• SE = always causes diarrhea, other GI symptoms include upset stomach, nausea, abdominal pain
• Taking with food helps ↓ GI side effects
• Check renal function before and during tx (BUN, creatinine)
• Lower dose (1.2 mg followed by 0.6 mg one hour later) is as effective as high dose but w/ less SE
Allopurinol – xanthine oxidase inhibitor, uric acid reducer, tx gout/prevent flares and kidney stones
• SE = skin rash, flu symptoms, painful or little urination, drowsiness/dizziness
• Monitor renal (BUN, creatinine) and liver function
Febuxostat (Uloric) – xanthine oxidase inhibitor, uric acid reducer for pts with gout/prevent flares
• SE = gout flares, nausea, mild rash, liver problems, heart attack symptoms
• Monitor liver and renal function
• Patient education = gout may worsen with therapy initially (can take NSAID or colchicine for up to
6 months w/ beginning of tx)
Probenecid (Benemid) & Sulfinpyrazone (Anturane) – uric acid reducer, uricosuric agent
• SE = frequent urination, N/V, HA, dizziness, skin rash
• Is NOT an anti-inflammatory, used for CHRONIC gout management
• Watch CBC for blood dycrasias
Corticosteroids – ends in “sone” (prednisone), used to tx RA, lupus, asthma, allergies, etc.
• SE = high BP, weight gain, muscle weakness, insomnia
• Adverse effect of corticosteroids after six months or longer = worry about osteoporosis, can also
worsen diabetic control
• Pt needs vitamin supplements to help prevent osteoporosis, check blood glucose levels
• Report black tarry stools and abdominal pain
• Adrenal suppression w/ long-term therapy (s&s = malaise, myalgia, fever, hyptension) so DO NOT
stop abruptly
• Tapering is necessary to prevent withdrawal symptoms
• If dose of corticosteroid exceeds 1 gram, prescribe a PPI (omeprazole)
Cox-1 Pathway – systemic, present in all tissues, blocking these account for GI adverse rxn
Page 1 of 14
, Page 2
Cox-2 Pathway – inducible enzyme produced in response to pain and inflammation
NSAIDS (ibuprofen, naproxen, celecoxib, ketorolac) – 1st line for mild to moderate pain, inflammation
• Ibuprofen = non-selective cox-2 inhibitor, decreases prostaglandins, antipyretic, inhibiting cox 1
gives GI side effects
Page 2 of 14
