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 Following his third episode of gouty arthrits, a 50-
year-old man sees you in the clinic. Each case was
successfully treated acutely; however, your patient
is interested in trying to prevent further episodes.
He is not on regular medications and has a normal
physical examination today. Blood work reveals an
elevated serum uric acid level and otherwise
normal renal function and electrolytes. A 24-hour
urine collection for uric acid reveals that he is
under-excreting uric acid. Suspecting that this is a
case of recurrent gout, you place him on
probenecid
Questions
1. What is the mechanism of action of
probenecid?
2. Which drug could have their excretion
inhibited by probenecid?
Summary
A 50-year-old man with recurrent gout
is prescribed probenecid
Mechanism of action of
probenecid
 Inhibits secretion of organic acids and
decreases reabsorption of uric acid,
causing a net increasing in secretion
Other drugs whose secretion could
be inhibited
Penicillin
Indomethacin
methotrexate

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Clinical Case 8

  • 1.
  • 2.  Following his third episode of gouty arthrits, a 50- year-old man sees you in the clinic. Each case was successfully treated acutely; however, your patient is interested in trying to prevent further episodes. He is not on regular medications and has a normal physical examination today. Blood work reveals an elevated serum uric acid level and otherwise normal renal function and electrolytes. A 24-hour urine collection for uric acid reveals that he is under-excreting uric acid. Suspecting that this is a case of recurrent gout, you place him on probenecid
  • 3. Questions 1. What is the mechanism of action of probenecid? 2. Which drug could have their excretion inhibited by probenecid?
  • 4. Summary A 50-year-old man with recurrent gout is prescribed probenecid
  • 5. Mechanism of action of probenecid  Inhibits secretion of organic acids and decreases reabsorption of uric acid, causing a net increasing in secretion
  • 6. Other drugs whose secretion could be inhibited Penicillin Indomethacin methotrexate