PHARMACYKNOWLEDGE.CO.UK - FREE RPSGB and GPhC UK Pre Reg Past exam paper questions, answers AND revision guide

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Pre-Registration Exam Practice Questions

GOUT Past exam Answers

a

3

b

2

WHAT YOU NEED TO KNOW

Acute gout

Medication: NSAIDS(apart from aspirin), COLCHICINE, CORTICOSTEROIDS

NSAIDs in gout:

NSAIDS such as indometacin, diclofenac, ibuprofen, are commonly used for treatment of acute gout to reduce inflammation and pain. Aspirin, however, should not be used in gout and will make it worse.

Colchicine

Colchicine acts by inhibition of leukocyte migration into the joint by reducing the production of chemotaxis. Colchicine is as effect as NSAIDS in treatment of gout, however, the risk of toxicity is greater. Colchicine is useful for patients with heart failure as it does not cause fluid retention (NSAIDS may cause fluid retention). It can also be useful for patients receiving anticoagulants.

Risk of toxicity

The risk of toxicity if colchicine is taken at higher doses is fatal and dangerous. Patients should follow the directions. Signs of toxicity include diarrhoea and vomiting, treatment should be stopped when symptoms are relieved. The BNF instructs that:

“Treatment of gout, initially 1mg, then 500mcgs no more frequently than every 4 hours until pain is relieved or vomiting or diarrhoea occur, max, 6mg per course, course not to be repeated within 3 days”

Contraindications and cautions:

Gastrointestinal disease -  Colchicine may exacerbate gastrointestinal diseases.

Pregnancy – tetragenicity in animal studies.

Thiazides - May precipitate gout, as they may reduce clearance of uric acid

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