A 27 y/o man with gouty arthritis has a 24 hr uric acid concentration of 600mg. He is currently on indomethacin. Which of the following is the recommended treatment for the chronic gouty arthritis at this stage?
A. Alluprinol
B. Probenecid
C. Indomethacin
D. Colchicin
E. NSAID
Normal values fall between 3.0 and 7.0 mg/dL.
Allopurinol b/c guys seem to be an overproducer
If that did not work
Long term Maintenance with: Colchicine
Well since undersecrtors is the more common scenario it could be prebenecid.
Alibi give us a good explanation on how to choose btw allo or prob.
Good Question by the way
Probenecid-- pts is already on NSAID and since most pts are undersecretors give him probenecid
probenecid . cut off is 800 for 24 urine uric acid. All under that - probenecid, over allopurinol.
Indo - fist line for acute, colchicin less tolerable second choice for acute attack
what options!!!.
becauseC and E are same so they are wrong answers.
anyway we use C, D, E for acute gout.
and we use A & b after the acute phase ended.
the q asks about chronic tx:
the answere is A or E depend on UA in urine
( i do not know nl value)