Gout- Probenecid DI

Question 1

Probenecid drug class

Answer 1

Uricosuric

Question 2

Probenecid MoA

Answer 2

Competitively inhibits the reabsorption of uric acid at the proximal convoluted tubule, –> promotes its excretion and reduces serum UA levels

Question 3

Probenecid dosing

Answer 3

250mg PO BID x1wk, may increase to 500mg PO BID; increase to MDD of 2g QD as needed in div. doses

Question 4

Probenecid RENAL dosing

Answer 4

Avoid use in CrCl <30ml/min

Question 5

Avoid probenecid use in history of what?

Answer 5

Kidney stones

Question 6

Probenecid DDIs (drugs only)

Answer 6

PCN
MTX
Carbapenems (doripenem, meropenem)
Salicylates

Question 7

PCN, MTX, carbapenem DDI with probenecid

Answer 7

Increases concentration due to decreased renal secretion; they will compete with probenecid for entry into the renal tubules

Question 8

DDI with probenecid and salicylates

Answer 8

Decreases probenecid efficacy

Question 9

Probenecid in the treatment guidelines

Answer 9

Allopurinol and febuxostat > probenecid > pegloticase

AKA second line option