• What is the mechanism of action of colchicine in the treatment of gouty arthritis?

Colchicine is a selective inhibitor of microtubuli and spindle formation in macrophages  and leukocytes. It also inhibits chemotaxis.

• What are the indications for colchicine’s use, its side-effects and dose? Especially ensure that you know precisely how colchicine must be used during an acute gout attack.

Indication: Acute gout (in patients intolerant to NSAIDS)

Side Effects: gastric bleeding, liver/kidney damage, bone marrow suppression, alopecia.

Dose: 0.5 - 1 mg

• Which other drugs can be used for the treatment of an acute gout attack?

NSAIDS( Diclofenac, Piroxicam, Indomethacin), Glucocorticoids( Prednisone, Betamethasone)

• To which group of drugs does probenecid belong?  How does this group of drugs act?

It is a uricosuric drug; It increases excretion of uric acid by competing with uric acid for reabsorption in proximal tubule in kidney.

• How does allopurinol act; what are its indications, precautions and important interactions

Mechanism of action: Irreversible inhibitors of xanthine oxidase, decreases uric acid production

Indications: Chronic gout

Precautions:  increases [xanthine] and [hypoxanthine], avoid in acute gout attack. Can induce acute gout (use with NSAIDs)