Acute Gout Attack

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2. Diagnosis: Acute gout attack

3. Condition:

4. Vital signs: tid

5. Activity: Bed rest with bedside commode

6. Nursing: Keep foot elevated; support sheets over foot; guaiac stools.

7. Diet: Low purine diet.

8. Special Medications:

-Ibuprofen (Motrin) 800 mg, then 400-800 mg PO q4-6h OR

-Diclofenac (Voltaren) 25-75 mg tid-qid with food OR

-Indomethacin (Indocin) 25-50 mg PO q6h for 2d, then 50 mg tid for 2 days, then 25 mg PO tid OR -Ketorolac (Toradol) 30-60 mg IV/IM, then 15-30 mg IV/IM q6h or 10 mg PO tid-qid OR

-Naproxen sodium (Anaprox, Anaprox-DS) 550 mg PO bid OR -Methylprednisolone (SoluMedrol) 125 mg IV x 1 dose THEN -Prednisone 60 mg PO qd for 5 days, followed by tapering. -Colchicine 2 tablets (0.5 mg or 0.6 mg), followed by 1 tablet q1h until relief, max dose of 9.6 mg/24h. Maintenance colchicine: 0.5-0.6 mg PO qd-bid.

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