A nurse is caring for a client who has developed gout. Which of the following medications should the nurse prepare to administer?

Choice A rationale Spironolactone is a potassium-sparing diuretic typically used to treat hypertension, edema, or heart failure. It works by antagonizing aldosterone receptors in the distal renal tubules, leading to the excretion of sodium and water while retaining potassium. It has no pharmacological mechanism to lower uric acid levels or reduce the inflammatory response associated with gout. Normal serum potassium levels are 3.5 to 5.0 mEq/L, and this medication requires monitoring to prevent hyperkalemia during therapy. Choice B rationale Allopurinol is a xanthine oxidase inhibitor used as a maintenance medication to treat gout. It works by reducing the production of uric acid in the body. Gout is caused by hyperuricemia, where serum uric acid levels often exceed 6.8 mg/dL, leading to the deposition of urate crystals in joints. By lowering uric acid levels, allopurinol prevents the formation of these crystals and reduces the frequency of acute gouty attacks. It is essential for long-term management. Choice C rationale Alprazolam is a benzodiazepine used primarily for the treatment of anxiety disorders and panic attacks. It works by enhancing the effects of gamma-aminobutyric acid, which is an inhibitory neurotransmitter in the central nervous system. While it provides sedation and muscle relaxation, it does not address the underlying pathophysiology of gout, which is a metabolic and inflammatory condition. It would be inappropriate for treating joint pain or high uric acid levels in a gouty client. Choice D rationale Zolpidem is a non-benzodiazepine sedative-hypnotic medication used for the short-term treatment of insomnia. It interacts with the GABA-BZ receptor complex to induce sleep. While a client with gout may have difficulty sleeping due to intense joint pain, zolpidem is not a treatment for gout itself. It does not possess analgesic or anti-inflammatory properties and does not affect uric acid metabolism. The nurse should prioritize medications that directly target the inflammatory process or uric acid production.