Medicine & USMLE

Colchicine

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Musculoskeletal Pharm
  1. Aspirin
  2. Acetaminophen
  3. N-Acetylcysteine (NAC)
  4. Celecoxib
  5. NSAIDs
  6. Leflunomide
  7. Bisphosphonates
  8. Teriparatide
  9. Cyclobenzaprine
  10. Dantrolene
  11. Etanercept
  12. TNF Inhibitors (Infliximab, Adalimumab. Certolizumab, Golimumab)
  13. Allopurinol/Febuxostat
  14. Probenecid
  15. Colchicine
  16. Rasburicase

Summary

Colchicine is an anti-inflammatory drug used to treat gout, a type of arthritic inflammation. Colchicine achieves this reduction in inflammation by blocking microtubule polymerization, which impairs the inflammatory response of neutrophils. Clinically, colchicine is first-line in the acute treatment of gout flares, along with NSAIDs.  Patients taking colchicine commonly experience GI side effects like abdominal pain, as well as nausea and vomiting.

Key Points

  • Colchicine
    • Mechanism
      • Inhibits microtubule polymerization
        • Binds and stabilizes tubulin, preventing its aggregation
        • Impairs neutrophil migration (chemotaxis), phagocytosis, degranulation
        • Also inhibits leukotriene B4 (LTB4) production
    • Indications/Clinical Use
      • Acts as Anti-inflammatory agent
      • Treats acute gout flares
        • First-line along with NSAIDs for resolution of acute gout flares
        • May be used to prevent gout flares in chronic gout
        • Reduced inflammatory response to uric acid crystals
    • Adverse Effects
      • Causes Gastrointestinal irritation
      • Causes agranulocytosis
      • Causes myopathy
      • Avoid in people with impaired renal function or elderly (more toxicity)