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

When Colchicine is administered it binds to the intracellular protein tubulin, inhibiting polymerization into microtubules which then prevents leukocyte migration and phagocytosis. By preventing the migration of leukocytes to the side of inflammation, ingestion of urate crystals and release if more inflammatory mediators will not occur. Colchicine also inhibits the formation of leukotriene B4 and IL-1β

2. 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.

Colchicine is used to treat gout and in between gout attacks.

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

Other drugs include NSAIDs such as Indomethacin, Diclofenac, Piroxicam.

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

Probenecid is used for chronic gout and falls under uricosuric drugs. These drugs compete with uric acid for reabsorption in the proximal tubule located in the kidney.

5. How does allopurinol act; what are its indications, precautions and important interactions?

Allopurinol inhibits Xanthine oxidase which then prevents Xanthine from forming uric acid in the body. This drug is used for chronic gout. Allopurinol can induce acute gout if not taken with NSAIDs. A caution to be taken is to be aware of the increased effects of cyclophosphamide which inhibits the metabolism of probenecid and oral anticoagulants which increases iron concentration.

Colchicine or NSAIDs are given initially with Allopurinol to help prevent gouty arthritis episodes.