Allopurinol Drug Study

Friday, February 20, 2009

In making a Drug Study, the following elements must be present: Generic Name and the Brand name (not all brands, just the brand used by the patient), Action, Indication, Pregnancy Category, Drug Classification, and Contraindication, Adverse Effect, Drug interaction and Nursing Consideration/Intervention…. Most clinical instructors preferred this to be in a long bond paper in printed or handwritten with paper in landscape.


Allopurinol

Brand name: Apo-Allopurinol (CAN), Purinol (CAN), Zyloprim

Pregnancy Category C

Drug class: Antigout drug

Therapeutic actions

Inhibits the enzyme responsible for the conversion of purines to uric acid, thus reducing the production of uric acid with a decrease in serum and sometimes in urinary uric acid levels, relieving the signs and symptoms of gout


Indications

· Management of the signs and symptoms of primary and secondary gout

· Management of patients with malignancies that result in elevations of serum and urinary uric acid

· Management of patients with recurrent calcium oxalate calculi whose daily uric acid excretion exceeds 800 mg/day (males) or 750 mg/day (females)

· Orphan drug use: treatment of Chagas' disease; cutaneous and visceral leishmaniasis

· Unlabeled uses: amelioration of granulocyte suppression with fluorouracil; as a mouthwash to prevent fluorouracil-induced stomatitis


Contraindications

· Contraindicated with allergy to allopurinol, blood dyscrasias.


Adverse effects

Headache, drowsiness, peripheral neuropathy, neuritis, paresthesias, Rashes--maculopapular, scaly or exfoliative--sometimes fatal, Nausea, vomiting, diarrhea, abdominal pain, gastritis, hepatomegaly, hyperbilirubinemia, cholestatic jaundice, Exacerbation of gout and renal calculi, renal failure, Anemia, leukopenia, agranulocytosis, thrombocytopenia, aplastic anemia, bone marrow depression


· Increased risk of hypersensitivity reaction with ACE inhibitors

· Increased toxicity with thiazide diuretics

· Increased risk of rash with ampicillin

· Increased risk of bone marrow suppression with cyclophosphamide, other cytotoxic agents

· Increased half-life of oral anticoagulants

Nursing considerations

· Administer drug following meals.

· Force fluids--2.5 to 3 L/day to decrease the risk of renal stone development.

· Check urine alkalinity--urates crystallize in acid urine; sodium bicarbonate or potassium citrate may be ordered to alkalinize urine.

· Arrange for regular medical follow-up and blood tests.


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