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Acute gout NSAID risk — GPhC CRA MCQ

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HardMusculoskeletal TherapeuticsAcute gout NSAID riskGPhC CRA

A 70-year-old man with previous peptic ulcer disease asks to buy ibuprofen for an acute gout flare. He takes aspirin 75 mg, ramipril and bendroflumethiazide. eGFR is 54 mL/min/1.73 m². What is the most appropriate alternative?

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Correct answer: B — Refer for prescriber assessment of colchicine or corticosteroid treatment

NSAIDs are high risk in this patient because of ulcer history, aspirin use, ACE inhibitor and diuretic therapy, and reduced renal function. Acute gout may be treated with colchicine or corticosteroids where appropriate after clinical assessment. Topical NSAIDs are unlikely to treat an acute gout flare adequately. Starting high-dose allopurinol during the acute attack is not appropriate for immediate symptom relief.

Reference: BNF; NICE CKS