Page 18 - RxExam's Naplex Theory Book Part 2

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Dose Special Notes

Pegloticase 2). Pegloticase (Krystexxa) is a pegylated uric acid specific enzyme
(Injection) indicated for the treatment of chronic gout in adult patients refractory
to conventional therapy. Gout refractory to conventional therapy
occurs in patients who have failed to normalize serum uric acid and
whose signs and symptoms are inadequately controlled with xanthine
oxidase inhibitors at the maximum medically appropriate dose or for
whom these drugs are contraindicated. It is NOT recommended for the
treatment of asymptomatic hyperuricemia.

3). Patients should receive pre-infusion medications (e.g.
antihistamines, corticosteroids, acetaminophen), to minimize the risk of
anaphylaxis and infusion reactions.

4). Anaphylaxis and infusion reactions have been reported to occur
during and after administration of Pegloticase (Krystexxa). Anaphylaxis
may occur with any infusion, including a first infusion, and generally
manifests within 2 hours of the infusion. However, delayed type
hypersensitivity reactions have also been reported.

5). The risk of anaphylaxis and infusion reactions is higher in patients
who have lost therapeutic response. Monitor serum uric acid levels
prior to infusions and consider discontinuing treatment if levels
increase to above 6 mg/dL, particularly when 2 consecutive levels
above 6 mg/dL are observed.

6). Infusion site reactions, gout flares, urticaria, dyspnea, chest
discomfort, chest pain, erythema and pruritus are also reported with
the therapy.

C). Uric Acid Excretion Enhancer

Probenecid 1. Gout: 1). Probenecid is a uricosuric and renal tubular blocking agent. It
(Tablet) 250 mg PO BID for inhibits the tubular reabsorption of urate, thus increasing the urinary
1 week followed excretion of uric acid and decreasing serum urate levels. Effective
by 500 mg PO BID uricosuria reduces the miscible urate pool, retards urate deposition,
thereafter. and promotes resorption of urate deposits.

2). Probenecid is indicated for:

a). For treatment of the hyperuricemia associated with gout and gouty
arthritis.
b). As an adjuvant to therapy with penicillin or with ampicillin,
methicillin, oxacillin, cloxacillin, or nafcillin, for elevation and
prolongation of plasma levels by whatever route the antibiotic is given.

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