• What is the mechanism of action of colchicine in the treatment of gouty arthritis. It is a selective inhibitor of micro-tubules and spindle formation macrophages and leukocytes ( thus inhibiting mitosis) Also inhibits chemotaxis .Decrease leukocytes metabolism , thus reducing lactic acid formation and increasing PH
• What are the indications for colchicine’s use, its side-effects and dose? Especially ensure that you know precisely how colchicine must be used during an acute gout attack

Indication- acute gout arthritis

Side effects- gastric discomfort , diarrhea , nausea , abdominal pain , gastric bleeding at high dose, liver damage , kidney disease , bone marrow suppression , peripheral neuritis , alopecia

Dose- 0.5-1mg immediately , followed by 0.5 mg every 6 hours until the pain relief or gastric discomfort is reached . max 2.5 mg in first 24 hours

No more than 6 mg over 4 day

Course may not be repeated within 3 day.

• Which other drugs can be used for the treatment of an acute gout attack?

Prednisone ,triamcinolone , methylprednisolone

• To which group of drugs does probenecid belong?  How does this group of drugs act?

Probenecid belongs to the uricosuric   , that lowers  uric acid in your body by assisting  the kidneys in excreting excess uric acid.

• How does allopurinol act; what are its indications, precautions and important interactions?

It reduces the conversion of xanthine to uric acid , thus reducing the production of uric acid

Thus it increases xanthine and hypoxanthine

Indication – chronic gout

Precautions – avoid in acute gout attack

Interactions- has no known severe interactions with other drugs

 

2.7 blog exercise b

• Which vascular changes can be observed before and during migraines?

Before there is vasodilation which induces migraine and it is followed by vasoconstriction.

• What is the role of serotonin in migraine headaches?

Serotonin is a chemical necessary for communication between nerve cells . it can cause narrowing of blood vessels throughout the body , thus when serotonin levels migraine result.

• How is ergotamine used during a migraine attack?

Is only effective if taken with first signs of migraine , can cause direct vasoconstriction especially for intracranial arteries.

• Which side-effects are experienced with ergotamine use? Which contra‑indications exist for using ergotamine?

Nausea & vomiting , hallucination and confusion, diarrhea , gangrene , retroperitoneal fibrosis , tachycardia

Contraindications

Coronary , cerebral & peripheral diseases , uncontrolled hypertension , hepatic and renal impairment and pregnancy.

• Which other drugs can be used for an acute migraine attack?  What is the action of all of these drugs?

NSAIDs , aspirin , cyclizine  , paracetamol

• Name the drugs which can be used for migraine prophylaxis, as well as their specific side effects and precautions

Propranolol, clonidine, flunarizine , topiramate ,pizotifen

Side effects : bradycardia , drowsiness , git disturbances , sexual dysfunction and nightmares.

Precaution – do not use if you have asthma , heart failure , pregnancy , depression and type 1 diabetes.