12-27-2013, 10:02 AM
as far as i know, probenecid is a uricosuric agetn which inhibits resorbtion of uric acid in pct thus increase excretion, its contraindication is that you dont use it in renal failure
and allopurinol - xanthine oxidase inhib - decrease xanthine to uric acid, minimal increase in excretion of uric acid
my question is - when renal status is NOT compromised - normal renal function - which would you choose and why?
refernce for this qeustion is NBME 6 question 18
A 57 yr old man comes to the physician coz of 1 day h/o swelling and severe pain of his rite knee that worsens w/ movement of the knee. He has no h/o serious illness. Temp-98.9, pulse-80, resp- 16, bp- 138/78. Examination of rt knee shows warmth, erythema, diffuse tenderness and moderate effusion. Aspiration of knee jt reveals cloudy fluid, fluid analysis shows WBC count 9000. Microscopic exam shows negatively birefringent, needle shaped crystals. Which is most appropriate initial pharmacotherapy?
A-Allopurinol
B-Hydroxychloroquine
C-Indomethacin
D-Prednisone
E-probenecid
any thoughts
and allopurinol - xanthine oxidase inhib - decrease xanthine to uric acid, minimal increase in excretion of uric acid
my question is - when renal status is NOT compromised - normal renal function - which would you choose and why?
refernce for this qeustion is NBME 6 question 18
A 57 yr old man comes to the physician coz of 1 day h/o swelling and severe pain of his rite knee that worsens w/ movement of the knee. He has no h/o serious illness. Temp-98.9, pulse-80, resp- 16, bp- 138/78. Examination of rt knee shows warmth, erythema, diffuse tenderness and moderate effusion. Aspiration of knee jt reveals cloudy fluid, fluid analysis shows WBC count 9000. Microscopic exam shows negatively birefringent, needle shaped crystals. Which is most appropriate initial pharmacotherapy?
A-Allopurinol
B-Hydroxychloroquine
C-Indomethacin
D-Prednisone
E-probenecid
any thoughts