Musculoskeletal system

Question 1

Acute treatment gout

Answer 1

1. High doses NSAID: 
diclofenac sodium/potassium
etoricoxib
indometacin
ketoprofen 
naproxen
sulindac
2. oral colchicine if NSAID are C/I - GIVE IF PT HAS HF OR ON ANTICOAGULANTS
3. oral or parenteral corticosteroids

Question 2

Long term treatment gout

Answer 2

1. allopurinol (reduces the formation of uric acid from purines)
2. Febuxostat
3. Sulfinyrazone given in treatment of hyperuricemia as excretes uric acid in urine
   Start 1-2 weeks after acute attack settled - DO NOT START DURING ACUTE ATTACK:
   - may exacerbate acute attack at the beginning - give NSAID or colchicine as prophylactic cover and for 1 mth after hyperuricemia has been corrected
   - continue same dose if pt has acute attack whilst on drugs
   -