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    Acute Gout Management

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    Acute gout management

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    Acute Gout Management

    Uploaded by

    mefav7778520
    48 views2 pages
    Acute gout management

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    Acute gout management

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    Acute gout management

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    48 views2 pages

    Acute Gout Management

    Uploaded by

    mefav7778520
    Acute gout management

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Gout and Hyperuricemia

    TABLE 3
    Drugs Used in the Management of Acute Gout

    DRUG DOSAGE SIDE EFFECTS/COMMENTS

    NSAIDS Contraindicated in patients with peptic ulcer disease or


    (selected) systemic anticoagulation; side effects include gastropathy,
    nephropathy, liver dysfunction, central nervous system
    Indomethacin 25 to 50 mg four dysfunction and reversible platelet dysfunction; may cause fluid
    (Indocin) times daily overload in patients with congestive heart failure

    Naproxen 500 mg two times


    (Naprosyn) daily

    Ibuprofen 800 mg four times


    (Motrin) daily

    Sulindac 200 mg two times


    (Clinoril) daily

    Ketoprofen 75 mg four times daily


    (Orudis)

    Colchicine 0.5 to 0.6 mg orally Dose-dependent gastrointestinal side effects; improper


    every hour until relief intravenous dosing has caused bone marrow suppression, renal
    or side effects occur, failure and death (see text)
    or until a maximum
    dosage of 6 mg is
    reached

    Corticosteroids

    Oral Prednisone, 0.5 mg Fluid retention; impaired wound healing


    per kg on day 1, taper
    by 5.0 mg each day
    thereafter
    DRUG DOSAGE SIDE EFFECTS/COMMENTS

    Intramuscular Triamcinolone May require repeat injections; risk of soft tissue atrophy
    acetonide (Kenalog),
    60 mg
    intramuscularly,
    repeat in 24 hours if
    necessary

    Intra-articular Large joints: 10 to 40 Preferable route for monoarticular involvement


    mg*

    Small joints: 5 to 20
    mg*

    ACTH† 40 to 80 IU Repeat injections are commonly needed; requires intact


    intramuscularly; pituitary-adrenal axis; stimulation of mineralocorticoid release
    repeat every 8 hours may cause volume overload
    as necessary

    NSAIDs = nonsteroidal anti-inflammatory drugs; ACTH = adrenocorticotropic hormone.

    *—Using triamcinolone hexacetonide (Aristospan Intralesional), triamcinolone acetonide or methylprednisolone (Medrol).

    †—To be administered in an inpatient setting only.

    Copyright © 1999 by the American Academy of Family Physicians.


    This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that
    printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied,
    printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in
    writing by the AAFP. Contact [email protected] for copyright questions and/or permission requests.

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