USMLE

Allopurinol

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Musculoskeletal Drugs
  1. Azathioprine
  2. Corticosteroids
  3. Sulfasalazine
  4. TNF Inhibitors
  5. Immunosuppressants (Cyclosporine, Mycophenolate, Tacrolimus)
  6. Acetaminophen
  7. NSAIDs
  8. Colchicine
  9. Allopurinol
  10. Rasburicase
  11. Dantrolene
  12. Muscle Relaxants
  13. Bisphosphonates: Alendronate, Risedronate

Summary

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Key Points

  • Allopurinol (Zyloprim)
    • Mechanism
      • Xanthine oxidase inhibitor
        • Lowers uric acid (urate) levels
    • Clinical Use
      • Gout prevention
        • Used to prevent an attack, is not particularly useful with an acute gout attack. NSAIDs or colchicine are more appropriate for acute situations.
        • Can prevent uric acid kidney stone formation
        • Patient should increase fluid intake
          • Increased fluid intake will also aid in the prevention of kidney stones
      • Tumor lysis syndrome (TLS)
        • An adverse effect of chemotherapy
        • Killed cancer cells release genetic material which is degraded to form uric acid, causing gout
    • Side Effects and Adverse Reactions
      • Stevens-Johnson Syndrome
        • Report rash immediately
      • Visual changes
        • Can result from prolonged use of allopurinol
        • Encourage patient to receive yearly eye exam