Probenecid is chosen for chronic urate-lowering therapy in a patient with gout. In which clinical situation would this drug be inappropriate?

• A Patient has mild hyperlipidaemia
• B Patient has coexisting hypertension treated with losartan
• C Patient requires concurrent penicillin therapy
• D Patient has a history of recurrent calcium oxalate renal stones ✓

Explanation

Probenecid is uricosuric: it inhibits reabsorption of uric acid in the proximal tubule, increasing urinary urate concentration. This raises the risk of urate stone formation and makes it unsuitable in patients with a history of nephrolithiasis or with overproduction hyperuricaemia. Losartan itself is mildly uricosuric and is compatible, probenecid actually prolongs penicillin half-life by blocking its tubular secretion, and dyslipidaemia is irrelevant to its use.

Reference: Goodman and Gilman's The Pharmacological Basis of Therapeutics, 14th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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