Pharmacy PEBC Practice Exam

TK is a 63 year old male with chronic kidney disease (Cr Cl = 29 mL/min/1.73m2) and gout. He experienced his last gout attack about 2 months ago. Today his toe is extremely painful, hot, red and swollen. At a walk-in clinic, he receives a prescription for naproxen 500 mg po bid for 5 days. TK’s other current medication is pravastatin 20 mg po hs. What drug therapy problem should the pharmacist identify for TK?

1. Naproxen is inferior to indomethacin for the treatment of acute gout.

2. The duration of naproxen treatment is too short.

3. Naproxen should be avoided in patients taking pravastatin.

4. Naproxen should be avoided in patients with renal dysfunction.

The correct answer is: Naproxen should be avoided in patients with renal dysfunction.

Naproxen should be avoided in patients with renal dysfunction, as it can further impair kidney function and potentially lead to more damage. In TK's case, he has chronic kidney disease and his creatinine clearance (Cr Cl) is already low at 29 mL/min/1.73m2. Therefore, prescribing naproxen puts him at risk for developing acute kidney injury. In addition, TK is only receiving a short 5-day course of naproxen, so it is not a duration issue. Naproxen is also not inferior to indomethacin, as both are commonly used and recommended for the treatment of acute gout. While naproxen and pravastatin can be taken together, the pharmacist should be sure to monitor TK's kidney function and adjust dosages if necessary.