Rosh Emergency Medicine Practice Test 2025 - Free Emergency Medicine Practice Questions and Study Guide

The primary treatment for an acute gout attack is nonsteroidal anti-inflammatory drugs (NSAIDs), such as indomethacin. NSAIDs work by reducing inflammation and alleviating pain, which is critical during an acute exacerbation of gout characterized by sudden, intense pain and swelling in the affected joints.

Using NSAIDs can help decrease the inflammatory response associated with the accumulation of urate crystals in the joints, which is the underlying cause of a gout attack. This class of medication is usually effective in providing rapid relief of symptoms, making it a preferred first-line treatment option.

Other treatments, such as glucocorticoids and colchicine, can also be effective in managing an acute gout attack, but they may not be the first choice for everyone, and are often considered when NSAIDs are contraindicated or not tolerated. Ice application, while it may help reduce discomfort, does not address the inflammatory process directly or provide the analgesic effects that NSAIDs do. Thus, NSAIDs remain the cornerstone of acute gout management.