CC Nov 2015 Gout and medications

echoecho's version from 2015-11-27 21:20


Question Answer
What % of the population in Western countries is affected by gout?1-2%
How many times more often are men affected compared to women?3-9 times
List 6 recognized risk factors for gout?1) family hx 2) obesity 3) renal impairment 4) alcohol use 5) high-purine diet 6)fructose consumption
What medical conditions are associated with gout?1) DM 2) metabolic syndrome 3) cardiovascular disease (especially heart failure)
What medical condition increases the risk of gout?HTN
What medication class are associated with a higher incidence of gout?diuretics (thiazide and loop)
How do diuretics cause gout?they increase net urate reabsorption in the proximal tubule
Whys should the choice of antihypertensive medications be made carefully in the presence of gout?because 51-74% of patients with gout also have HTN
*** What are the hazard ratios for gout in a diuretic, a thiazide diuretic and a loop diuretic?1.48; 1.44; 2.31
If any antihyertensive medication other than a diuretic was used, how did this affect the gout risk?it decreased it
What was the cause of diuretics and gout? the urate levels
In a study in 2012, there was a "trend toward a higher risk for acute gouty arthritis attacks in patients on loop and thiazide diuretics, but the magnitude and independence is not consistent", what did the authors suespect might be the actual risk factors for develeoping gout? the indications for diuretics (HTN, heart failure)
What two medications can lower serum uric acid levels with a relative risk for gout of 0.9 and 0.8, respectively?1) calcium-channel blockers 2) losartan (Cozaar)
Was the above seen with other ARBs or ACEIs?no
True or false, longer use of either losartan or CCB was assicated with progressively lower risk for gout?true
What 3 anti-HTN medication groups increased the relative risk for incident gout?1) beta blockers 2) diuretics 3) ACEI
In patients where diuretics is a necessary medication, does a dx of gout mandate discontinuation of the diuretics?no
How does adding Losartan or an ACEI to the diuretic minimize the risk of gout attacks?1) Losartan lowers the uric acid levels 2) ACEI minimizes the increase of uric acids
Was there some benefit with the combination of calcium channel blockers plus diuretics in a patient with gout?yes
Do potassium-sparing diuretics incease the risk of incident gout?yes
*** SUMMARY = What 3 medical diseases are associated with gout?1) DM 2) metabolic syndrome 3) cardiovascular disease especially heart failure
*** What medical condition increases the risk of gout with a relative risk of 2.311?HTN
*** SUMMARY = What medication groups are associated with an increased risk of out, although the magnitutde is not consistent?diuretics (loop and thiazide)
*** SUMMARY = What two medications groups lower the risk of gout?1) Losartan (Cozaar) 2) calcium channel blockers