Why no Probenecid for acute Gout! - USMLE Forums
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Old 10-07-2013
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Drug Why no Probenecid for acute Gout!

why probenecid and allopurinol should not be used for the treatment of acute gout?

thanks...
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Old 10-08-2013
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Originally Posted by yeshwanter View Post
why probenecid and allopurinol should not be used for the treatment of acute gout?

thanks...
As both will compete for excretion, thus reducing uric acid secretion = attack of gout.

Probenecid is useful with penicillins which also use similar competing acid secretion mechanism in the nephron, thus prolonging the stay of penicillins in the body!!
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Old 10-08-2013
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As both will compete for excretion, thus reducing uric acid secretion = attack of gout.

Probenecid is useful with penicillins which also use similar competing acid secretion mechanism in the nephron, thus prolonging the stay of penicillins in the body!!
but when probenecid is used in chronic gout, it has a uricosuric action..it prevents the reabsorption of uric acid from the tubules..
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but when probenecid is used in chronic gout, it has a uricosuric action..it prevents the reabsorption of uric acid from the tubules..
So, FA mentions it like this for Probenecid:

"Inhibits reabsorption of uric acid in PCT (also inhibits secretion of penicillin)"

The former part explains its use in chronic use by not allowing any amount of uric acid secreted to come back.

And the latter part explains why it can precipitate an already high level of uric acid in acute gout into an attack.
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Old 10-08-2013
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Sorry i dnt understand later part(block penicillin secreation)
What is the relation between penicillin and uric acid..
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Sorry i dnt understand later part(block penicillin secreation)
What is the relation between penicillin and uric acid..
No problem.. Dr Lionel explained it like this, I think:

Various acids (incl uric acid) use the same transport protein in nephron for secretion as is used by penicillins & cephalosporins, explaining competitive excretion between the two.
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