Which medication is most helpful during the acute phase of gout?

• A. Allopurinol
• B. Indomethacin
• C. Salicylates
• D. Broad spectrum antibiotics

Answer: (B)

Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that is particularly effective for managing the pain and inflammation associated with acute gout attacks. During the acute phase, the primary goal is to alleviate the immediate inflammatory response and reduce the severe pain that typically accompanies a gout flare.

Indomethacin works by inhibiting the production of prostaglandins, which are mediators of inflammation. This action leads to a decrease in swelling, redness, and pain in the affected joint. When a patient experiences an acute gout attack, using an NSAID like indomethacin can provide rapid symptom relief, making it the preferred choice during this critical phase.

Other medications, such as allopurinol, while important in the long-term management of gout by lowering uric acid levels, are not effective during acute attacks and may even exacerbate symptoms if initiated during a flare. Salicylates can have mixed effects and are not considered first-line treatment for gout flares. Broad-spectrum antibiotics are unrelated to gout treatment, as gout is not an infectious condition. Thus, indomethacin stands out as the most suitable medication for addressing the acute pain and inflammation associated with gout.