Pharmacology Musculoskeletal Meds #4

Question

The patient with complaints of great toe pain and inflammation has a new diagnosis of gout after verification of laboratory results and visit with the primary health care provider. The nurse anticipates instruction on new medications and is planning to speak with the patient on which of the medications? Select all that apply.

Answers

  1. Ascorbic acid 500 mg by mouth twice daily.
    • Rationale:

      This answer is not correct because vitamin C or ascorbic acid has been studied in its use for prevention of development of gout. It is not used for treatment of gout but considered for prevention of gout.

  2. Colchicine 1.2 mg by mouth initially followed by .06 mg an hour later at first sign of attack.
    • Rationale:

      This answer is correct because gout medication treatment includes use of colchicine, allopurinol, and ibuprofen. Treatment of pain and inflammation in the acute attach stage is treated with colchicine and ibuprofen.

  3. Allopurinol 100 mg by mouth daily.
    • Rationale:

      This answer is correct because gout medication treatment includes use of colchicine, allopurinol, and ibuprofen. Long term treatment requires a uric acid lowering agent such as allopurinol.

  4. Ibuprofen 600 mg by mouth three times daily for acute gout attack.
    • Rationale:

      This answer is correct because gout medication treatment includes use of colchicine, allopurinol, and ibuprofen. Treatment of pain and inflammation in the acute attach stage is treated with colchicine and ibuprofen.

  5. Hydrocodone/acetaminophen by mouth every 6 to 8 hours as needed for pain.
    • Rationale:

      This answer is not correct because narcotics are not typically the treatment choice for gout. NSAIDs or steroids are usually the first choice and control inflammation and pain.

Overview

Gout medication treatment includes use of colchicine, allopurinol, and ibuprofen.

Explanation

The answer is B, C, D. Treatment of pain and inflammation in the acute attach stage is treated with cochicine and ibuprofen. Long term treatment requires a uric acid lowering agent such as allopurinol. Other uric acid reducers may include probenecid, febuxostat, and pegloticase; however, allopurinol may have fewer side effects.

Learning Outcomes

Treatment of pain and inflammation in the acute attach stage is treated with colchicine and ibuprofen. Long term treatment requires a uric acid lowering agent such as allopurinol. Other uric acid reducers may include probenecid, febuxostat, and pegloticase; however, allopurinol may have fewer side effects. Vitamin C or ascorbic acid has been studied in its use for prevention of development of gout.

Test Taking Tip

A way to remember what allopurinol does as a medication. Think of the “-purin-” in allopurinol stands for “purine” (that the body has difficulty breaking down in gout), and the “uri-” for uric acid that allopurinol removes to prevent uric acid kidney stones.

Video Rationale