Class
Medication
What it treats
MOA
S/E
Monitor/BBW/Comments
Anti-Gout
Colchicine (Colcrys)
Treat and prevent gout attacks and also Behcets syndrome
Lower dose (1.2 mg follo
...
Class
Medication
What it treats
MOA
S/E
Monitor/BBW/Comments
Anti-Gout
Colchicine (Colcrys)
Treat and prevent gout attacks and also Behcets syndrome
Lower dose (1.2 mg followed by 0.6 mg one hour later) is just as effective as high dose but with less side effects
Inhibits microtubule formation at cellular level, limits neutrophil migration and aggregation to tissues, and inhibits mitosis
**decrease inflammatory response to urate crystal deposits; used in acute attacks**
DIARRHEA
GI upset: N/V/D, abdominal pain
*taking with food helps decrease GI side effects
Check renal function before and during treatment (BUN/Creatinine)
Impaired renal or hepatic function requires decreased doses or frequency to prevent s/e including neuromyopathic symptoms
*Interacts with NSAIDS (AVOID)
**Report immediately: proximal muscle weakness, myalgia, and neuropathy (usually resolve in 3-4 weeks after
stopping med)
Xanthine Oxidase Inhibitor
Allopurinol (Zyloprim, Lopurin)
Chronic management of hyperuricemia in patients with gout
100 mg and 300 mg tablets; FDA approval for up to 800 mg/d in divided doses
*uric acid reducer: prevents kidney stones
Competitive inhibitor of XO enzyme. Has feedback on salvage pathway effect and decreases total purine production
**inhibit synthesis of uric acid by inhibiting xanthine oxidase conversion of hypoxanthine and xanthine to uric acid**
Rare occurrence of severe allopurinol hypersensitivity syndrome.
S/E: Skin rash, flu symptoms, painful or little urination, drowsiness/dizziness
*STOP if maculopapular rash is seen
Interactions with various antibiotics, anti- epilepsy medications, immunosuppressants, warfarin, and diuretics.
*AVOID with azathioprine and mercaptopurine.
Renal clearance dose modification needed.
May rarely cause decreased blood counts MONITOR: Liver and Kidney function
*Interacts w/ ACE inhibitors (AVOID)
Xanthine Oxidase Inhibitor
Febuxostat (Uloric)
Chronic management of hyperuricemia in patients with gout
Hepatically metabolized non-purine analog; acts with non-competitive inhibition
S/E: gout flares, nausea, mild rash, liver problems, heart
attack symptoms
*Symptoms may get worse initially: patients should be treated concurrently with NSAID or colchicine for up to 6 months
40 mg and 80 mg tabs; FDA approved for 80 mg/day
**inhibits synthesis of uric acid by inhibiting xanthine oxidase conversion of hypoxanthine and xanthine to uric acid**
*Hepatically metabolized
Monitor Liver Function: Liver disease is a contraindication to use.
AVOID with azathioprine and mercaptopurine.
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