This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pharmacology
[{'content': 'Best drug for acute gout in a patient with renal impairment is: \nSelect and explain. \nA. Naproxen, B. Probenecid, C. Allopurinol, D. Sulfinpyrazone', 'role': 'user'}, {'content': 'Answer: A \nExplanation: Naproxen: The anti-inflammatory activity is stronger and it is particularly potent in inhibiting leucocyte migration - may be more valuable in acute gout: dose 750 mg stat followed by 250 mg 8 hourly till attack subsides. It is also recommended for rheumatoid arthritis and ankylosing spondylitis. Because of longer t ½ , regular use can effectively suppress platelet function. Gastric bleeding is more common than with ibuprofen. Naproxen carries lower thrombotic risk than diclofenac, etoricoxib, etc. Dose should be reduced in the elderly.\nNaproxen is marketed as active single S(-) enantiomer preparation, which poses less renal burden. However, some R(+) enantiomer is formed in vivo due to inversion.\n\nUricosuric drugs like probenecid and sulﬁnpyrazone are ineﬀective in the presence of renal\xa0 insuﬃciency.\nAllopurinol is a drug of choice for most cases of chronic gout. Renal\xa0 impairment\xa0 increases\xa0 the\xa0 incidence\xa0 of rashes and other reactions to allopurinol.\n\n\u200bReference: Essentials of Medical Pharmacology Eighth Edition KD\xa0 TRIPATHI\xa0 page no 217', 'role': 'assistant'}]