GOUT-ACUTE MANAGEMENT
SUMMARY
1. NSAIDs, corticosteroids, or oral colchicine are all appropriate 1st line agents for acute gout. Know that the earlier any treatment is initiated the better the response.
2. Low-dose oral colchicine (1.2 mg x 1 dose, then 0.6 mg 1 hour later) followed by prophylactic doses if needed can be used in patients instead of NSAIDs.
3. This low-dose regimen has equivalent efficacy and better GI tolerability.
4. Anti-hyperuricemic drugs for chronic treatment of gout (allopurinol, febuxostat) should not be started during an acute attack, but should be continued if the patient is already taking the drug.
Reference(s)
Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].
