Acute attack of gout patient came with non tolerance to NSAIDS, which drug to be given –
**Core Concept**
Gout is a form of inflammatory arthritis characterized by sudden onset of intense pain, redness, and swelling in the affected joint, typically the big toe. The condition is caused by elevated levels of uric acid in the blood, leading to its deposition in joints as monosodium urate crystals. In the acute phase, the primary goal of treatment is to alleviate pain and inflammation.
**Why the Correct Answer is Right**
Colchicine is a medication that can be used to treat acute gout attacks, especially in patients who are intolerant to NSAIDs. It works by inhibiting microtubule polymerization, which in turn reduces the migration of neutrophils into the affected joint, thereby decreasing inflammation. Colchicine is particularly useful in patients who cannot tolerate NSAIDs due to gastrointestinal side effects or other contraindications.
**Why Each Wrong Option is Incorrect**
**Option A:** Corticosteroids can be used to treat acute gout, but they are not the first-line choice in patients who are intolerant to NSAIDs. Corticosteroids can be administered orally or intra-articularly, but they may not be as effective as colchicine in reducing pain and inflammation.
**Option B:** Allopurinol is a xanthine oxidase inhibitor that is used to prevent gout attacks by reducing uric acid production. However, it is not indicated for the treatment of acute gout attacks and may even worsen symptoms if started during an acute episode.
**Option C:** This option is blank and cannot be evaluated.
**Clinical Pearl / High-Yield Fact**
In patients with acute gout, it is essential to differentiate between gout and other causes of acute arthritis, such as pseudogout or septic arthritis. A prompt diagnosis and initiation of appropriate treatment can significantly improve patient outcomes and prevent complications.
**Correct Answer: C. Colchicine**