MSK

Gout Medications

Musculoskeletal

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Examples

colchicineallopurinolfebuxostatprobenecidindomethacin

Prefix / Suffix: -xostat for xanthine oxidase inhibitors

Physiology

Gout occurs when uric acid crystals trigger intense joint inflammation. Acute therapy treats inflammation, while long-term therapy lowers uric acid to prevent flares.

Mechanism of Action

Colchicine reduces neutrophil activity. NSAIDs reduce prostaglandin-mediated inflammation. Allopurinol/febuxostat reduce uric acid production. Probenecid increases uric acid excretion.

Indications

  • Acute gout flare
  • Chronic gout prevention
  • Hyperuricemia with recurrent flares or tophi
  • Tumor lysis prevention with selected agents

Side Effects / Adverse Effects

  • GI upset and diarrhea with colchicine
  • Rash or severe hypersensitivity with allopurinol
  • Hepatic effects with febuxostat
  • Kidney stones with probenecid
  • NSAID GI/renal effects

Contraindications

  • Severe renal or hepatic impairment with colchicine caution
  • Azathioprine/mercaptopurine interaction with allopurinol
  • History of severe allopurinol reaction
  • Uric acid kidney stones with probenecid

Nursing Considerations

  • Teach that urate-lowering therapy is usually continued during flares unless provider changes plan
  • Encourage hydration unless restricted
  • Monitor uric acid, renal function, liver tests, and rash
  • Start long-term urate lowering with flare prophylaxis when ordered
  • Report severe rash immediately

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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.