Acute gouty arthritis. Special management considerations in alcoholic patients

The initial treatment of acute gout is normally accomplished with the use of oral colchicine or one of the nonsteroidal anti-inflammatory drugs. However, in the setting of chronic alcoholism, the use of these agents may pose a significant risk to the patient. Prior to the use of antigout medications, the alcoholic patient should be assessed for the presence of gastrointestinal disease, anemia, and hepatic or renal dysfunction. The safest treatment in an alcoholic is intravenous colchicine or only analgesics. (JAMA1982;247:58-59)