allopurinol (Zyloprim, Purinol) increases release of chemotactic factors
A & B
A, B & C
Important sources of uric acid:
amino acids
carbon dioxide
diet
A & B
A, B & C
Rational indication(s) for allopurinol (Zyloprim, Purinol) administration:
chronic tophaceous gout;when tophi reabsorption more rapid with uricosuric agents
when probenecid or sulfinpyrazone cannot be used
presence of renal functional impairment
in a patient with recurrent renal stones
all of the above
Previously most popular drug for treating inflammation of acute gouty arthritis -- NSAIDs now more commonly used because of diarrhea associated with earlier medication:
allopurinol (Zyloprim, Purinol)
colchicine
probenecid (Benemid)
sulfinpyrazone (Anturane)
acetaminophen (Tylenol, Panadol)
effective in management of mild to moderate pain, when anti-inflammatory action is not necessary
penicillamine (Cuprimine)
sulfasalazine (Azulfidine)
acetaminophen (Tylenol, Panadol)
etodolac (Lodine)
piroxicam (Feldene)
Probably the initial step in acute gouty arthritis attack:
polymorphonuclear leukocytes migration into the joint
increased numbers of mononuclear phagocytes (macrophages)
urate crystals phagocytosis by synoviocytes
prostaglandin, lysosomal &, interleukin 1 release
Probable direct effect of colchicine (mechanism of action):
direct membrane stabilization
binds to intracellular tubulin -- preventing/reducing microtubule formation
decreases purine synthesis directly
prevents IL-1 release directly
none of the above
Reduces likelihood of urate stone formation:
high-level urine volume
acidification of urine pH
both
neither
Reduces uric acid synthesis: for management of gout--