CorConsult Rx: Evidence-Based Medicine and Pharmacy · Mike Corvino, PharmD, BCPS, BCACP, CDE and Cole Swanson, PharmD

Managing Gout ACPE-Accredited

·1 hr 1 min·5 clips

Patients describe even a bedsheet moving over their toe as excruciating during a gout attack.

This accredited continuing education episode on gout features hosts Cole and Mike, pharmacists who produce evidence-based medical content. They humorously recount how a hurricane-induced power outage forced them to re-record the episode, losing their original material. The hosts explain gout's historical label as the "disease of kings," its link to elevated serum uric acid above 6.8 mg/dL, and its higher prevalence in men. They detail how purine metabolism produces uric acid and list medications like diuretics, cyclosporine, and low-dose aspirin that can decrease its clearance. Podagra, or gout in the big toe, is the initial manifestation in about half of cases and eventually affects 90% of patients. Acute gout flares involve an inflammatory response to crystals, reaching maximum intensity within 8-12 hours, while pseudogout has a more insidious onset. For acute treatment, colchicine is effective if started within 36 hours, with specific dosing and adjustments for kidney impairment. Nonsteroidal anti-inflammatory drugs like indomethacin or naproxen and corticosteroids are other options, with combination therapy for severe, polyarticular flares. The newly FDA-approved injectable canakinumab (Ilaris) is for flares refractory to those standard treatments. Maintenance urate-lowering therapy with xanthine oxidase inhibitors like allopurinol or febuxostat is recommended for patients with tophi, frequent attacks, or chronic kidney disease. The hosts note a case of allopurinol hypersensitivity and mention HLA-B*5801 allele testing for patients of Asian descent. The tone is conversational and informal, filled with friendly banter and self-deprecating humor about their recording mishaps. Listeners seeking practical, accredited pharmacy continuing education on gout management will appreciate this episode. Those preferring a more structured, formal lecture style might find the casual digressions less engaging.

As heard by us

A practical acute gout refresher with clear treatment steps and CE value.

This episode lays out acute gout treatment as a simple decision path. Within 36 hours, colchicine is the main option. After that, NSAIDs or corticosteroids take over, and combination therapy comes in when one treatment is not enough.

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Need a gout treatment refresher you can actually use when the next flare question lands?

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