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
f...
Class Medication What it treats MOA S/E Monitor/BBW/Comments
Check renal function before and during
Anti-Gout Colchicine Treat and prevent gout Inhibits microtubule DIARRHEA treatment (BUN/Creatinine)
(Colcrys) attacks and also formation at cellular GI upset: N/V/D,
Behcets syndrome level, limits neutrophil abdominal pain Impaired renal or hepatic function requires
migration and decreased doses or frequency to prevent s/e
Lower dose (1.2 mg aggregation to tissues, *taking with food including neuromyopathic symptoms
followed by 0.6 mg and inhibits mitosis helps decrease GI side
one hour later) is just effects *Interacts with NSAIDS (AVOID)
as effective as high **decrease
dose but with less side inflammatory response **Report immediately: proximal muscle
effects to urate crystal deposits; weakness, myalgia, and neuropathy
used in acute attacks** (usually resolve in 3-4 weeks after
stopping med)
Interactions with various antibiotics, anti-
Xanthine Oxidase Allopurinol Chronic management Competitive inhibitor of Rare occurrence of epilepsy medications,
Inhibitor (Zyloprim, of hyperuricemia in XO enzyme. Has severe allopurinol immunosuppressants, warfarin, and
Lopurin) patients with gout feedback on salvage hypersensitivity diuretics.
pathway effect and syndrome.
100 mg and 300 mg decreases total purine *AVOID with azathioprine and
tablets; FDA approval production S/E: Skin rash, flu mercaptopurine.
for up to 800 mg/d in symptoms, painful or
divided doses **inhibit synthesis of little urination, Renal clearance dose modification
uric acid by inhibiting drowsiness/dizziness needed.
*uric acid reducer: xanthine oxidase
prevents kidney stones conversion of *STOP if May rarely cause decreased blood counts
hypoxanthine and maculopapular rash is
xanthine to uric acid** seen MONITOR: Liver and Kidney function
*Interacts w/ ACE inhibitors (AVOID)
Hepatically metabolized *Symptoms may get worse initially:
Xanthine Oxidase Febuxostat Chronic management non-purine analog; acts S/E: gout flares, patients should be treated concurrently
Inhibitor (Uloric) of hyperuricemia in with non-competitive nausea, mild rash, with NSAID or colchicine for up to 6
patients with gout inhibition liver problems, heart months
attack symptoms
40 mg and 80 mg tabs; **inhibits synthesis of Monitor Liver Function: Liver disease is a
FDA approved for 80 uric acid by inhibiting *Hepatically contraindication to use.
mg/day xanthine oxidase metabolized
conversion of AVOID with azathioprine and
hypoxanthine and mercaptopurine.
xanthine to uric acid**
, Class Medication What it treats MOA S/E Monitor/BBW/Comments
*ENCOURAGE FLUIDS r/t risk of stone
Uricosuric Agent Probenecid Chronic management Blocks the transport of S/e: frequent development and possible development of
(Benemid, of hyperuricemia in acidic media across urination, N/V, nephrolithiasis
Probalan) patients with gout transporters in the headache, dizziness,
kidneys skin rash *monitor CBC for blood dycrasias
500 mg tablets: FDA
approval for BID **inhibit renal tubular NOT used in acute Monitor BUN/Creatinine clearance
dosing for a total dose reabsorption of urate attacks
of 2,000 mg/day or and therefore increase *do not take aspirin or salicylates
less excretion of uric acid via Take medication with food or milk to
the kidneys and decrease decrease GI s/e
*Uric acid reducer serum uric acid**
Corticosteroid Prednisone Acute gouty arthritis Inhibits gene High BP, weight gain, MONITOR BLOOD SUGARS r/t causing
transcription for COX-2, muscle weakness, hyperglycemia
RA, lupus, asthma, cytokines, cell adhesion insomnia, systemic
allergies molecules, and inducible immunosuppressant, Patient may need vitamin supplements
nitric oxide synthase. potential for decreased (vitamin D, calcium, bisphosphonate) to
Variable dosing: 35 Creates multi-level wound healing and help prevent osteoporosis
mg/d and 0.5 mg/kg suppression of increased infectious
daily dosing over 5-10 inflammation risk, acute After 6 months worry about osteoporosis
days development of
hyperglycemia, Report black/tarry stools and abdominal
increased intra-ocular pain
pressure, mood
changes, peripheral Adrenal suppression w/ long-term therapy
edema, easy bruising (malaise, myalgia, fever, HTN)
Adrenal Suppression Tapering is necessary to prevent
occurs with long- withdrawal symptoms
term therapy
If dose exceeds 1 gram, prescribe a PPI
(omeprazole)
**Do not take with active infections: may
worsen fungal infections
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