Family Nurse Practitioner Exam

Which drug is considered effective therapy for treating pain during an acute exacerbation of gout?

1. Acetaminophen (Tylenol)

2. Systemic steroids

3. Indomethacin (Indocin)

4. Allopurinol (Zyloprim)

The correct answer is: Indomethacin (Indocin)

Indomethacin, a nonsteroidal anti-inflammatory drug (NSAID), is considered an effective therapy for treating pain during an acute exacerbation of gout. The mechanism of action involves the inhibition of cyclooxygenase, which subsequently reduces the production of prostaglandins – compounds that mediate inflammation and pain. As gout is characterized by sudden and intense pain due to inflammation in the joints, indomethacin can help alleviate this discomfort and reduce swelling effectively. In contrast, while systemic steroids can be used for acute gout attacks, they are not the first line of treatment and are generally considered when NSAIDs are contraindicated or ineffective. Acetaminophen, although an analgesic, lacks the anti-inflammatory properties necessary to effectively manage the acute inflammation seen during a gout flare. Allopurinol is primarily used as a long-term urate-lowering therapy to prevent future gout attacks rather than treating acute flares since it might actually worsen symptoms if given during an active attack. Thus, indomethacin is favored specifically for its effectiveness in addressing the acute symptoms of gout.