Which of the following drugs would be most
appropriate to treat the following patient's pain?
A 45-year-old man complained to his physician of severe pain at the base of his left big toe which had kept him awake the previous night. He described the pain as excruciating. On physical examination, the first metatarsophalangeal joint was warm and tender, and the entire periarticular area was red and swollen.
A. Propoxyphene B. Indomethacin C. Auranofin D. Aspirin E. Probenecid F. Allopurinol
Indomethacin-the symptoms and signs of the patient suggest that he is suffering from an acute gouty attack.indomethacin is commonly prescribed for the treatment of acute attack of gout and manyconsider it to be the drug of choice. colchicine is another drug highly effective in the goutyattack, but is less frequently used today because of its potential adverse effects.a) the analgesic action of propoxyphene (an opioid analgesic) is too weak to be useful in thegouty attack.c) gold compounds are useful in rheumatoid arthritis but are without effect in gouty arthritis.d) nsaids other than indomethacin have been proved effective in the treatment of acute goutyarthritis. aspirin however can inhibit (when given in small doses) the excretion of uric acid bythe kidney and therefore should not be used for analgesia in patients with gout.e, f) these drugs can decrease uric acid plasma levels in patients with gout but they cannotrelieve the pain of a gouty attack.