A 50-year-old man with recurrent gout is treated with probenecid to prevent further episodes. Probenecid works by inhibiting the secretion of organic acids and decreasing uric acid reabsorption, leading to increased uric acid secretion. The drug may also inhibit the excretion of penicillin, indomethacin, and methotrexate.

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