Question:
A 50 year old patient wakes up with excruciating pain at the base of the great toe with redness and swelling. Which would be the most desirable drug?
A 50 year old patient wakes up with excruciating pain at the base of the great toe with redness and swelling. Which would be the most desirable drug?
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Think about whether this drug treats the acute attack or lowers uric acid for the long run.
Updated On: Jul 7, 2026
- Allopurinol
- Probenecid
- Sulfinpyrazone
- Indomethacin
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Verified By Collegedunia
The Correct Option is D
Solution and Explanation
Step 1: Understanding the Question.
Sudden, severe pain, redness, and swelling at the base of the great toe describe an acute attack of gout, often called podagra. The question asks for the best drug to give right now, during the attack.
Step 2: Key Concept.
Acute gout attacks are treated with drugs that calm the inflammation quickly, such as NSAIDs like indomethacin or colchicine. Drugs that lower uric acid levels are started later, once the attack has settled, because changing uric acid levels suddenly can actually worsen an acute attack or trigger a new one.
Step 3: Detailed Explanation.
Allopurinol blocks the enzyme xanthine oxidase, lowering uric acid production over time. Starting it during an acute attack can shift urate crystals around and worsen the pain, so it is not given now.
Probenecid is a uricosuric drug, it makes the kidneys remove more uric acid. Like allopurinol, it is meant for long term control, not the acute attack, and can worsen symptoms if started too early.
Sulfinpyrazone is also a uricosuric drug with the same long term role and the same risk of worsening an acute attack if started during one.
Indomethacin is a strong NSAID that reduces the inflammation and pain of the acute attack quickly, without disturbing uric acid levels, making it the right choice right now.
Step 4: Final Answer.
Indomethacin is the most desirable drug for this acute attack of gout.
Sudden, severe pain, redness, and swelling at the base of the great toe describe an acute attack of gout, often called podagra. The question asks for the best drug to give right now, during the attack.
Step 2: Key Concept.
Acute gout attacks are treated with drugs that calm the inflammation quickly, such as NSAIDs like indomethacin or colchicine. Drugs that lower uric acid levels are started later, once the attack has settled, because changing uric acid levels suddenly can actually worsen an acute attack or trigger a new one.
Step 3: Detailed Explanation.
Allopurinol blocks the enzyme xanthine oxidase, lowering uric acid production over time. Starting it during an acute attack can shift urate crystals around and worsen the pain, so it is not given now.
Probenecid is a uricosuric drug, it makes the kidneys remove more uric acid. Like allopurinol, it is meant for long term control, not the acute attack, and can worsen symptoms if started too early.
Sulfinpyrazone is also a uricosuric drug with the same long term role and the same risk of worsening an acute attack if started during one.
Indomethacin is a strong NSAID that reduces the inflammation and pain of the acute attack quickly, without disturbing uric acid levels, making it the right choice right now.
Step 4: Final Answer.
Indomethacin is the most desirable drug for this acute attack of gout.
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