-Probenecid (Benemid), 250 mg bid. Increase the dosage to 500 mg bid after 1 week, then increase by 500-mg increments every 4 weeks until the uric acid level is below 6.5 mg/dL. Max dose 2 g/d. Contraindicated during acute attack.
-Allopurinol (Zyloprim) 300 mg PO qd, may increase by 100-300 mg q2weeks. Usually initiated after the acute attack.
9. Symptomatic Medications: -Ranitidine (Zantac) 150 mg PO bid.
-Meperidine (Demerol) 50-100 mg IM/IV q4-6h prn pain OR -Hydrocodone/acetaminophen (Vicodin), 1-2 tab q4-6h PO prn pain
10. Labs: CBC, SMA 7, uric acid. UA with micro. Synovial fluid for light and polarizing micrography for crystals; C&S, Gram stain, glucose, protein, cell count.
X-ray views of joint. 24 hour urine for uric acid.
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