A 72-year-old man presents to the ED with
pain in his right big toe. The pain started this
morning and is getting progressively worse,
and he is unable to bear weight on that foot.
This is his fifth presentation to the ED in the
past 7 years for similar complaints. He says his
doctor gave him a medication to prevent the
attacks, but he does not remember the name
and hasn’t taken it in many months. He is
febrile, has a pulse of 90/min, and has a blood
pressure of 136/86 mm Hg. The first metatarsophalangeal joint of the right foot is swollen,
warm, and erythematous. It is exquisitely tender to palpation and there is decreased movement. He also has several nontender nodules
on the medial aspect of the big toes bilaterally,
alongside the first metacarpophalangeal joints
bilaterally, and on his ears. Which of the following is the best agent for acute management
of this patient’s condition?