Soru

A 71-year-old man presents to the primary care clinic with $24$ hours of severe, sudden-onset pain and swelling in his left big toe. He reports the pain woke him from sleep and is exacerbated by the light touch of his bedsheets. He has a medical history of ischemic cardiomyopathy with a left ventricular ejection fraction of $25\%$, chronic kidney disease stage 4 with a baseline eGFR of $22 \text{ mL/min/1.73 m}^2$, and poorly controlled type 2 diabetes mellitus with a recent HbA1c of $9.2\%$. Three weeks ago, he was hospitalized for an acute heart failure exacerbation, which required increasing his daily furosemide dose. Current medications include lisinopril, carvedilol, furosemide, empagliflozin, and aspirin. Vital signs are within normal limits. Examination reveals an erythematous, exquisitely tender, and swollen left first metatarsophalangeal joint. Arthrocentesis yields synovial fluid with $45,000 \text{ leukocytes/\mu L}$ ($85\%$ neutrophils). Polarized light microscopy demonstrates negatively birefringent, needle-shaped crystals. Gram stain is negative for organisms. Which of the following is the most appropriate next step in pharmacologic management?