A patient who is obese and has hypertension is taking a thiazide ...

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A patient who is obese and has hypertension is taking a thiazide diuretic and develops gouty arthritis, which is treated with probenecid.
 
  At a follow-up visit, the patient's serum uric acid level is 7 mg/dL, and the patient denies any current symptoms. The primary care NP should discontinue the probenecid and: a. prescribe colchicine.
  b. prescribe febuxostat.
  c. tell the patient to use an NSAID if symptoms recur.
  d. counsel the patient to report recurrence of symptoms.

Question 2

A patient who is newly diagnosed with type 2 diabetes mellitus has not responded to changes in diet or exercise. The patient is mildly obese and has a fasting blood glucose of 130 mg/dL. The patient has normal renal function tests.
 
  The primary care NP plans to prescribe a combination product. Which of the following is indicated for this patient? a. Metformin/glyburide (Glucovance)
  b. Insulin and metformin (Glucophage)
  c. Saxagliptin/metformin (Kombiglyze)
  d. Metformin/pioglitazone (ACTOplus met)

[dajones82]

Answer to Question 1

A
Colchicine is a first-line drug for preventing acute attacks. Because this patient has three risk factors, a preventive medication should be used. Febuxostat is a second-line preventive medication. The patient should not be treated on an as-needed basis.

Answer to Question 2

A
Obese patients with normal renal function and elevated fasting plasma glucose may be started on a combination of metformin and a second-generation sulfonylurea.

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Thanks

[dajones82]

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