Gout Management in the Elderly

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Which of the following is the recommended initial dose of allopurinol for urate-lowering therapy in elderly patients?

No specific dosing recommendation is provided for elderly patients

100 mg/day or less, with gradual titration as tolerated (correct)

300 mg/day, with rapid titration if well-tolerated

200 mg/day, regardless of comorbidities or concurrent medications

In elderly patients with dementia or cognitive impairments, what is the recommendation regarding urate-lowering therapy (ULT)?

ULT should be discontinued in all patients with cognitive impairments

ULT should be initiated regardless of cognitive status or gout history

ULT should be continued at the same dose as in patients without cognitive impairments

ULT should be discontinued if there is no history of tophaceous gout or repetitive acute gout flares (correct)

What is the recommended approach for managing acute gout flares in elderly patients during the first 3-6 months of urate-lowering therapy?

Use high-dose corticosteroids to rapidly control the flare

Use the lowest effective dose of colchicine or an NSAID as prophylaxis (correct)

Discontinue urate-lowering therapy until the flare resolves

Use colchicine or NSAIDs at the same dose as in younger patients

If an elderly patient experiences a high frequency of acute gout flares despite being on urate-lowering therapy, what is the recommended long-term management strategy?

Use colchicine, low-dose NSAIDs, or low-dose prednisone as long-term flare prophylaxis Signup and view all the answers

What is the recommendation regarding urate-lowering therapy for elderly women who become pregnant?

Recommendations for urate-lowering therapy will change based on potential adverse effects on the fetus or pregnancy Signup and view all the answers

What is the recommended approach for managing acute gout flares in elderly women, compared to men?

Use lower doses of colchicine or NSAIDs with gastroprotective therapy Signup and view all the answers

What is the effect of estrogen on gout incidence in women?

Decreases gout incidence Signup and view all the answers

Why is gout management in elderly patients considered complex?

The presence of comorbid conditions and progressive nature of the disease Signup and view all the answers

Which medication is NOT associated with an increased risk of developing gout?

Estrogen replacement therapy Signup and view all the answers

What is the main concern with using allopurinol in gout patients with advanced renal failure?

Toxic epidermal necrolysis Signup and view all the answers

Why are corticosteroids best avoided in elderly patients with gout?

They are associated with serious adverse events Signup and view all the answers

What is the recommended duration for using colchicine to prevent acute gout in elderly patients?

Less than 3 days Signup and view all the answers

Why are elderly patients with gout less likely to receive urate-lowering therapy?

Their first gout attack occurs during hospitalization for another condition Signup and view all the answers

Which factor contributes to the increased incidence of gout in women?

Higher uric acid levels during menopausal years Signup and view all the answers

Why should NSAIDs be used cautiously in gout patients with renal impairment?

Potential kidney damage and decreased GFR Signup and view all the answers

What is the most appropriate strategy for preventing acute gout in elderly patients according to current practice?

Combination of low-dose colchicine and allopurinol Signup and view all the answers

Gout Management in the Elderly

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