Correct Answers
What blood level do we expect to see elevated in a patient with gout? Uric acid
First line Tx for gout Corticosteroids, NSAIDs, or Colchicine
What is the typical treatment regimen for chronic gout? Allopurinol, Febuxostat, low dose
Colchicine (prophylaxis)
MOA of febuxostat inhibits xanthine oxidase ->decreased production of uric acid
Is allopurinol safe to use with patient who have renal dysfunction? Yes; Rx of choice for
pts with renal dysfxn or who overproduce uric acid
What is the initial dosage of colchicine for acute gout? 0.6mg TID on 1st day
OR
,1.2mg x 1 -> 0.6mgx1 in 1 hour; on subsequent days, 1-2/day until flare resolution
What is required to diagnose Osteoporosis? DXA scan
T score of -2.5 or lower
T score of -1 to -2.5 PLUS one of the following:
10yr prob. of hip Frx of 3% or more OR
10 yr prob of osteoperosis r/t frx of 20% or more
What is the most common fracture seen in Severe Osteoporosis? Hip & Vertebrae
What is the first-line treatment of osteoporosis? Bisphosphonates with calcium and
vitamin D supplementation.
Bisphophosphonates- examples Alendronate, ibandronate, risedronate, zolendronic acid
, "-dronate"
"-dron-"
Pt education for bisphosphonates Swallow tab whole
take with full glass of H2O
remain upright for at least 30min (60min for ibandronate)
Take medication on empty stomach
Possible AEs of bisphosphonates Esophagitis, osteonecrosis of the jaw, & hip frx
MOA of bisphosphonates Inhibits osteoclast bone resorption
Black box warning for Raloxifene Increased risk for VTE
Increased risk for death from stroke in PM women with Hx or risk of CAD
Bisphosphonates' contraindications esophageal disorders
CrCl < 30/ml/min
inability to sit or stand for <30 min