Gout is a common type of arthritis caused by high levels of uric acid in the blood that leads to urate crystal deposits in joints. It affects around 1-2% of adults in developed countries. Diet, genetics, comorbidities like hypertension and diabetes, and medications like diuretics are risk factors. Acute gout attacks are typically treated with NSAIDs, colchicine, or corticosteroids. Long-term management involves lowering uric acid levels through medications like allopurinol, febuxostat, or uricosuric drugs and lifestyle changes like diet modification and weight loss. Proper treatment can help prevent future gout attacks and dissolve urate crystals from joints.

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2. Introduction: Introduction Diagnosis Purine metabolism Diagnosis Management

17. Gout: acute attack trt Cochicin. NSAIDs steroids 0·5 mg three times daily Favored if no C/Is&for 1–2 ws. Paranteral &oral pred Rest/Ice Steoides Colchicin/ NSAIDs

18. Toxic effects of colchicine: Macrolides cyclosporine verapamil RF/HF Elderly Toxic effects of colchicine Statins

19. Urate - lowering therapy: Tophi Uric acid stones Indicated in: Recurrent attacks Chronic arthropathy

20. Non-drug Management: Stop diuretics Dietary changes Include: Stop alcohol weight loss

21. Dietary advices: Fructose Red meat/sea food. Avoid: Beer Spirits

22. Starting urate -lowering drugs: - Started 1-2 weeks after resolution of the acute attack. - Colchicin or NSAIDs for 3-6 months. Should be treated without interruption of urate-lowering therapy. Urate lowering drugs: Prevention of acute flares during maintenance trt: Flares

24. Cutaneous S/Es of Allopurinol increased with: RF Co-diurtics use Re Chalenge High dose

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