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level: Level 9 - Anti Gout

Questions and Answers List

level questions: Level 9 - Anti Gout

Question	Answer
• A plant alkaloid (Autumn crocus, Colchicum autumnale) • MOA: binds to tubulin, a microtubular protein, causing its depolymerization (disrupts cellular functions, such as mobility of granulocytes); blocks cell division by binding to mitotic spindle ANTI-INFLAMMATORY SPECIFIC FOR GOUT USUALLY EFFECTIVE WITHIN 12 HOURS FROM ADMINISTRATION (should be administered within 36 hrs of onset of attack to be effective) •N & V, abdominal pain, diarrhea •Chronic administration: myopathy, neutropenia, aplastic anemia, alopecia	COLCHICINE
•A xanthine oxidase inhibitor, a purine analog • MOA: reduces the production of uric acid by competitively inhibiting the last two steps in uric acid biosynthesis that are catalyzed by xanthine oxidase A/E: •HYPERSENSITIVITY, ESPECIALLY SKIN RASHES (most common) •DI: 6-mercaptopurine, azathioprine, theophylline	ALLOPURINOL
• Also a xanthine oxidase inhibitor but structurally unrelated to allopurinol • Has the same MOA, indications, drug interactions and adverse effects with allopurinol (LESSER RISK FOR RASH AND HYPERSENSITIVITY) • Has LESSER DEGREE OF RENAL ELIMINATION than allopurinol	FEBUXOSTAT
•MOA: a weak organic acid that promotes renal clearance of uric acid by INHIBITING THE URATE-ANION EXCHANGER in the proximal tubule that mediates urate reabsorption • Blocks tubular secretion of: • Penicillin (used to increase levels of beta-lactam antibiotics) • Methotrexate • Naproxen • Ketoprofen • Indomethacin	PROBENECID
•A RECOMBINANT FORM OF THE ENZYME URATE OXIDASE OR URICASE • MOA: CONVERTS URIC ACID TO ALLANTOIN, a water-soluble nontoxic metabolite that is excreted primarily by the kidneys	PEGLOTICASE