Which one is better???? gouty attack - nana79

[ArchivalUser]

Now I am really confused..... In a pacient with an acute attack of gout and renal insufficiency, the first line of treatment is Colchicine or Steroids?.
In kaplan q bank they said Colchicine can not be given in significant renal failure because it could accumulates in toxic levels, but in Master the boards and pharmacology flash cards they said Colchicine is the first line of treatment in pacients with renal failure where NSAIDS can not be used........
Please help!!!!

[ArchivalUser]

think that it is Colchicine ( decrease the dose by the half if GFR < or equal 50, and no colchicine if clearance < 10.
use ORAL Colchicine NO I/V.

[ArchivalUser]

its steroids in pts who cant tolerate colchicine or NSAIDS or renal failure cases