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Acute gout treatment — GPhC CRA MCQ

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ModerateMusculoskeletal TherapeuticsAcute gout treatmentGPhC CRA

A 58-year-old with acute pain and swelling of the first metatarsophalangeal joint asks for advice. He takes apixaban for atrial fibrillation and has a history of peptic ulcer disease. He has no fever. What is the most appropriate alternative?

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Correct answer: D — Refer for assessment and consider colchicine suitability

Acute gout can be treated with an NSAID, colchicine or corticosteroid depending on comorbidities and contraindications. NSAID use is less suitable in a patient taking apixaban with ulcer history because of bleeding risk. Allopurinol is not used as immediate analgesia for an acute attack. Referral or prescriber assessment is appropriate to select safe treatment.

Reference: NICE CKS; BNF