Aust Prescr
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Gout is a common inflammatory arthritis that is increasing in prevalence. It is caused by the deposition of urate crystals. Non-steroidal anti-inflammatory drugs, colchicine and corticosteroids are options for the management of acute gout. ⋯ It is clinically equivalent to allopurinol. Uricosuric drugs, such as probenecid, increase uric acid excretion. New drugs in this class will soon become available and are likely to have a role in the treatment of patients who do not respond to other drugs.
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Most patients with dementia have some behavioural and psychological symptoms. While aggression and agitation are easily recognised, symptoms such as apathy may be overlooked. Behavioural and psychological symptoms should be managed without drugs whenever possible. ⋯ They should be regularly monitored for adverse effects. If the patient's symptoms resolve with drug treatment, reduce the dose after two or three months. Stop the drug if the symptoms do not return.
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Mental illness is common in people with intellectual disability. They may also have physical health problems which can affect their mental state. Difficulties in communication can contribute to mental health problems being overlooked. ⋯ Prescribe the minimum effective dose and treatment length, and regularly monitor drug efficacy and adverse effects. There is insufficient evidence to support the use of psychotropics for challenging behaviour. They should be avoided unless the behaviour is severe and non-responsive to other treatments.