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?

• A. Pyrimidine antimetabolite
• B. Inhibitor of neutrophil recruitment
• C. Uricosuric drug
• D. Xanthine oxidase inhibitor

Hint:

Allopurinol, a xanthine oxidase inhibitor, is often the first-line therapy for chronic gout to lower uric acid levels. During an acute attack, anti-inflammatory agents such as colchicine or NSAIDs are used to manage symptoms.

Answer 1

The Correct Option is D

Pyrimidine antimetabolite: This is not the correct mechanism for treating gout. Pyrimidine antimetabolites are used in cancer and autoimmune diseases, not for managing elevated uric acid or gout.
Inhibitor of neutrophil recruitment: While neutrophil recruitment inhibition can be part of treating inflammatory conditions, it is not the primary mechanism for drugs used in managing gout.
Uricosuric drug: Uricosuric drugs, such as probenecid, help increase uric acid excretion in the urine. While they can be used in managing chronic gout, the first-line treatment during an acute gout attack is xanthine oxidase inhibitors, like allopurinol or febuxostat, to reduce uric acid production.
Xanthine oxidase inhibitor: This is the correct answer. Xanthine oxidase inhibitors, such as allopurinol and febuxostat, are the first-line drugs used to lower serum uric acid levels by inhibiting the enzyme that converts purines to uric acid, thereby preventing the formation of urate crystals and the resulting inflammatory response in gout. Thus, the correct answer is Xanthine oxidase inhibitor (4), as it is the first-line treatment for gout by reducing the production of uric acid.