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  1. Adrenaline injected with a local anaesthetic has the advantage that it reduces systemic toxicity of the local anaesthetic.
  2. Vasoconstrictors should not be used in secondary shock.
  3. Thearpeutic strategy to combat gout is to control the level of uric acid in blood below a certain value, i.e. 6 mg/dL. This will hinder the deposition of urate crystals.
  4. Indomethacin is considered the classic NSAID of choice in the management of acute gouty arthritis.
  5. Treatment strategies for treatment of chronic gout include the use of xanthine oxidase inhibitors to reduce the synthesis of uric acid or use of uricosuric drugs to increase uric acid excretion.
  6. Xanthine oxidase inhibitors (allopurinol, febuxostat) are 1st-line urate-lowering agents in chronic gout. Uricosuric agents (probenecid, sulfinpyrazone) are 2nd-line agents and may be used in patients who are intolerant to or fail to achieve adequate response with 1st-line agents i.e. xanthine oxidase inhibitors.
  7. Colchicine is a plant alkaloid that is used in the treatment of  acute gout.
  8. Colchicine has dual mechanism of action. For one it is anti-inflammatory and for second it is anti-mitotic. Both these actions are geared at neutrophils. Former action is by binding to tubulin (a microtubular protein) and causing its depolymerization, manifesting as cellular function disruption i.e. mobility is compromised. Later action is by binding to mitotic spindles, thus halting cell divison.
  9. Colchicine must be administered within 36 hours of onset of acute gout attack to be effective.
  10. NSAIDs and beta-blockers taken together have an interaction in which the beneficial effects of beta-blocker may decrease and cause an increase in blood pressure.