A patient experiencing an acute gout attack has received several doses of hourly oral colchicine. As the nurse prepares to administer the next dose, the patient begins vomiting. What action should the nurse take?

Question

a. Explain that this is a common side effect that will soon abate.
b. Administer an antiemetic and reschedule the dose.
c. Discontinue the medication and call the prescriber.
d. Ask the patient about the contents of his most recent meal.

Answer 1

C
If gastrointestinal (GI) symptoms develop, such as nausea, vomiting, diarrhea, or abdominal pain, colchicine should be discontinued immediately, regardless of status of joint pain.
GI symptoms are seen in up to 80% of patients during colchicine treatment of an acute gout at-tack. These symptoms are indicative of injury to the rapidly proliferating cells of the GI endothe-lium. The drug should be discontinued.
An antiemetic may be useful for abating the vomiting; however, continued administration of the drug can lead to further damage to the GI endothelium.
GI symptoms are characteristic side effects of colchicine, therefore a recent meal is highly un-likely to have precipitated the vomiting.