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Thiazide-associated gout — GPhC CRA MCQ

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HardCardiovascular TherapeuticsThiazide-associated goutGPhC CRA

A 71-year-old man takes bendroflumethiazide 2.5mg daily and ramipril 5mg daily. He presents with acute first metatarsophalangeal joint pain, serum urate is raised and renal function is stable. He asks whether his medicines could be contributing. What is the most appropriate alternative?

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Correct answer: A — Flag thiazide-associated gout risk to the prescriber and advise assessment of the acute attack.

Thiazide diuretics can increase urate and contribute to gout. Acute gout should be managed appropriately, and the need for the thiazide should be reviewed by the prescriber. Starting long-term urate-lowering therapy during an acute presentation without an agreed plan is not the best pharmacy action.

Reference: BNF; NICE CKS