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**Start of Template**
A/P
Patient has had a diagnosis of gout for quite some time per their report
Currently taking: {_}
No reported issues from medication per patient
Discussed that gout can be managed with one of the following: allopurinol, febuxostat, probenecid, or pegloticase.
Goal Uric acid level is < 5.8 per AAFP guidelines
Does patient have CKD: Yes {_} no
If CKD and stage 3 or higher, plan on reducing allopurinol dose to 100mg daily or less (if no risk factors can go up to 800mg per day of allopurinol in divided doses no greater than 300mg)
If patient has a history of CVD then it is important to avoid febuxostat, history of CVD: {_}
Discussed that febuxostat has an increased all cause mortality associated with it, and increased cardiovascular risk
-continue allopurinol
– Avoid purine containing foods such as: high fructose corn syrups, red meat, beer, and others as mentioned in the education given to patient as below
– Uric acid level
The above recommendations were made based on guidelines developed by the AAFP found at this link: https://www.aafp.org/pubs/afp/issues/2020/1101/p533.html
HPI
Gout:
Patinet has been taking current medication for quite some time per their report. No issues with the medication.
Last gout flare: {_}
Has tried for gout: {_}
**End of Template**