Question 1

Q: A patient presents with swelling in MCP joints, and his serum uric acid levels were found to be elevated. His physician prescribed a drug which is considered as the first line agent in the management of this condition. What is the mechanism of this drug?

Xanthine oxidase inhibitor. ***Xanthine oxidase inhibitor*** - The presentation of **swollen MCP joints** and **elevated uric acid** is highly suggestive of **gout**. - **Allopurinol**, a **xanthine oxidase inhibitor**, is the **first-line drug** for chronic gout management, reducing uric acid production. *Uricosuric drug* - **Uricosuric agents** like **probenecid** increase uric acid excretion, but they are generally **second-line** or used in specific cases, not first-line for most patients. - These drugs are typically only effective if there is **sufficient renal function** and are contraindicated in patients with a history of **kidney stones**. *Pyrimidine antimetabolite* - **Pyrimidine antimetabolites** like **5-fluorouracil** are primarily used in **chemotherapy** for certain cancers by interfering with DNA and RNA synthesis. - They have **no role** in the treatment of gout or hyperuricemia. *Inhibitor of neutrophil recruitment* - **Colchicine**, which inhibits neutrophil migration, is used to treat **acute gout flares** by reducing inflammation, but it's not the first-line agent for **long-term management** of hyperuricemia. - This mechanism targets the inflammatory response rather than the underlying **uric acid production** or excretion. [Practice more Pharmacology PYQs on OnCourse]

Question

A patient presents with swelling in MCP joints, and his serum uric acid levels were found to be elevated. His physician prescribed a drug which is considered as the first line agent in the management of this condition. What is the mechanism of this drug?

Accepted Answer

Xanthine oxidase inhibitor

Answer

Uricosuric drug

Answer

Pyrimidine antimetabolite

Answer

Inhibitor of neutrophil recruitment

FMGE 2022 — Pharmacology