Maryville Pharm Exam 3 | STUDY GUIDE
Reduce incidence of acute gout attacks
Colchicine use
relieves pain and discomfort (although it is not an analgesic)
inhibits migration of granulocytes to the
inflamed areas Reduces lactic acid
Colchicine Actions production by granulocytes
decreases deposition of uric acid
interferes with kinin formation and reduces phagocytosis
Overall effect is it decreases the inflammatory response to urate
crystals
Renal Failure- not effective in the presence of renal failure.
Colchicine cautions Poorly excreted with RF. Hepatic dysfunction- associated
with hepatotoxicity
Peptic ulcer disease or spastic colon- will worsen GI disturbances
Nausea, vomiting, diarrhea, and
Colchicine Adverse Effects abdominal pain Malabsorption of
vitamin B12
Elevated levels with RF may lead to myopathy, neuropathy, & muscle
weakness
1.2 mg initial dose followed by 0.6 mg one hour later or 1.8
Colchicine low dose therapy mg total. High dose is a 4.8 mg total dose. High dose is no
longer recommended because low dose is just as
effective with less side effects.
, Risk of Gout flare up when just starting
Febuxostat Patient teaching
Contraindicated in patients taking xanthine oxidase because
of increased risk of toxicity.
Adrenal Suppression
Osteoporosis- increased
Corticosteroid Adverse effects
when taken osteoclastic activity Worsen
> 6 months
Diabetic control
May mask infections
Report Tarry black stools or abdominal pain
Colchicine Monitoring BUN, Creatinine, Creatinine clearance, serum uric acid levels (goal is < 6).
Mask infections
Exacerbation of fungal infections
( don't use) HTN due to NA &
H20 retention
Edema with renal
disease
Corticosteroid adverse effects Osteoporosis
Altered glucose regulation in diabetics
Increased GI bleeding & perforation esp. with
PUD and UC pts. Altered growth &
development in children
Skin thinning &
atrophy Alopecia
Poor wound healing
Myopathy
Truncal obesity, moon face & buffalo hump
Corticosteroid monitoring BP, glucose, electrolytes, Bone Mineral Density, monitor for cataracts &
glaucoma
Steroid psychosis Delirium, agitation, insomnia, mood swings, severe depression
Avoid recurrence of underlying disease process
Reasons for steroid tapering
Gradually reverse adrenal suppression
Increased risk of cardiovascular
NSAID Black Box warnings thrombotic events Increased risk of life
threatening GI bleeding
, Increased risk of MI and stroke (Risk increases with duration of use)
Reduce incidence of acute gout attacks
Colchicine use
relieves pain and discomfort (although it is not an analgesic)
inhibits migration of granulocytes to the
inflamed areas Reduces lactic acid
Colchicine Actions production by granulocytes
decreases deposition of uric acid
interferes with kinin formation and reduces phagocytosis
Overall effect is it decreases the inflammatory response to urate
crystals
Renal Failure- not effective in the presence of renal failure.
Colchicine cautions Poorly excreted with RF. Hepatic dysfunction- associated
with hepatotoxicity
Peptic ulcer disease or spastic colon- will worsen GI disturbances
Nausea, vomiting, diarrhea, and
Colchicine Adverse Effects abdominal pain Malabsorption of
vitamin B12
Elevated levels with RF may lead to myopathy, neuropathy, & muscle
weakness
1.2 mg initial dose followed by 0.6 mg one hour later or 1.8
Colchicine low dose therapy mg total. High dose is a 4.8 mg total dose. High dose is no
longer recommended because low dose is just as
effective with less side effects.
, Risk of Gout flare up when just starting
Febuxostat Patient teaching
Contraindicated in patients taking xanthine oxidase because
of increased risk of toxicity.
Adrenal Suppression
Osteoporosis- increased
Corticosteroid Adverse effects
when taken osteoclastic activity Worsen
> 6 months
Diabetic control
May mask infections
Report Tarry black stools or abdominal pain
Colchicine Monitoring BUN, Creatinine, Creatinine clearance, serum uric acid levels (goal is < 6).
Mask infections
Exacerbation of fungal infections
( don't use) HTN due to NA &
H20 retention
Edema with renal
disease
Corticosteroid adverse effects Osteoporosis
Altered glucose regulation in diabetics
Increased GI bleeding & perforation esp. with
PUD and UC pts. Altered growth &
development in children
Skin thinning &
atrophy Alopecia
Poor wound healing
Myopathy
Truncal obesity, moon face & buffalo hump
Corticosteroid monitoring BP, glucose, electrolytes, Bone Mineral Density, monitor for cataracts &
glaucoma
Steroid psychosis Delirium, agitation, insomnia, mood swings, severe depression
Avoid recurrence of underlying disease process
Reasons for steroid tapering
Gradually reverse adrenal suppression
Increased risk of cardiovascular
NSAID Black Box warnings thrombotic events Increased risk of life
threatening GI bleeding
, Increased risk of MI and stroke (Risk increases with duration of use)
