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- Instruct patients with gout about the differences in the manifestations and management of its acute and chronic forms.
- Advise patients that treatment of gout requires monitoring for response to therapy and potential adverse effects.
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Instruct patients with gout about the differences in the manifestations and management of its acute and chronic forms.  |
- Instruct patients that:
- Acute gout attacks, consisting of red, swollen and painful joints, should be treated with anti-inflammatory medications and analgesics
- Management of chronic gout, consisting of hyperuricemia and ongoing deposition of monosodium urate crystals in tissues, requires drug treatment to decrease uric acid levels in blood and tissues by decreasing its production or increasing its excretion
- Starting therapy with uric acid-lowering agents or stopping it during an acute attack may worsen acute symptoms; however, occurrence of an acute attack in this setting does not mean that treatment has failed
- Prevention of recurrent attacks, tissue accumulation, and nephropathy requires lifetime diet modification and continuous drug therapy
- Uric acid levels should be checked 2-4 weeks after initiation of uric acid-lowering treatment to monitor adequacy of dose and adherence
| Background | Back to top
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Advise patients that treatment of gout requires monitoring for response to therapy and potential adverse effects. |
- Emphasize that regular follow-up is required to monitor response to therapy and potential adverse effects.
- Advise patients specifically about:
- Allopurinol hypersensitivity, consisting of fever, hepatotoxicity, vasculitis, and rash, which generally occurs within the first month of therapy
- Gastrointestinal and renal toxicity of nonsteroidal anti-inflammatory drugs
- Gastrointestinal, hematologic, and neurologic toxicity of colchicine
- Side effects of corticosteroids
| Background | Back to top
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| Grace P. Teal, MD (deceased) has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Howard A. Fuchs, MD, is a consultant for TAP Pharmaceuticals.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott. |
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The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
or PDFs may rapidly become obsolete. Therefore, PIER users should
compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
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PIER is copyrighted (c) 2009 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
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Gout
