Who gets the drug? - okieowl

[ArchivalUser]

A 50 y male comes with a swollen right great toe. you suspect gout.after initial treatment with NSAID's for arthritis you ordered serum uric acid.

Serum Uric acid is 10.5mg/dl.
you want to start treatment for reduction of uric acid.

what will be the next best step in management?

A. Start Allopurinol 100mg/d for 1 week.
B. Start Sulfinpyrazone 50-100mg twice daily.
C.Repeat Uric Acid Level after 1 week and then start Allopurinol or Sulfinpyrazone
D.Do a 24 hr urine uric acid determination

[ArchivalUser]

D..

[ArchivalUser]

d--

[ArchivalUser]

d---------

[ArchivalUser]

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[ArchivalUser]

D.Do a 24 hr urine uric acid determination

A Value under 800mg/d indicates under secretion of uric acid, which is amenable to uricosuric agents if renal function is preserved. Patient with >800mg/d uric acid are over producer and require Allopurinol.