DRUG DRUG
MECANISM OF ACTION
Inhibits xanthine oxidase, an enzyme involved in the (Allomaron, Allurase, synthesis of uric acid Drugmaker¶s Biotech without disrupting the Allopurinol, Elavil, biosynthesis of Llanol, Lopric, essential purine. Loricid, Purinase, Results in decreased Puristen, SYnol, acid level. Zelcron, Zyloprim) ALLOPURINOL
INDICATION
y
y
y
CLASSIFICATION:
y
Xanthine oxidase
y
inhibitor; antigout drug
STUDY
CONTRAINDICATION
SIDE EFFECTS
Severe renal impairment andCNS: Fever, drowsiness, headache, children except those with primary or paresthesia, secondary gout hyperuricemia secondary to peripheral hyperuricemia malignancy, idiopathic resulting from hemochromatosis, acute gouty neuropathy, neuritis. CV: Hypersensitivity chemotherapy attack, hypersensitivity. Lactation. vasculitis, necrotizing for angiitis. malignancies EENT: Epistaxis. recurrent GI: Diarrhea, nausea, calcium oxalate vomiting, abdominal renal calculi pain, gastritis, taste Recurrent loss, or perversion, trophaceous dyspepsia. deposits or uric GU: Renal failure, acid stones. uremia. Hematologic: Agranulocytosis, anemia, aplastic anemia, thrombocytpenis, leucopenia, leukocytosis, eosinophilia. Hepatic: Hepatitis, hepatic necrosis, hepatomegaly, cholestatic jaundice. Musculoskeletal: Arthralgia, myopathy. Treatment of
NURSING RESPONSIBILITY
y
y
Assess patient¶s history, gout may be secondary to disease such as acute or chronic leukemia, polycythemia vera, multiple myeloma or psoriasis. Assess for pain including location, characteristics, onset/duration, frequency, quality, intensity or severity of pain, precipitating factors.
y
Monitor uric acid levels every 2 weeks. Monitor renal function; check intake-output ratio, increase fluids to 2 L/day to prevent stone formation, toxicity, BUN, creatinine.
y
Monitor CBC and hepatic function at the start of therapy and periodically thereafter. Be alert for adverse reaction and drug interaction, anemia, hepatitis. Advaic patient to avoid hazardous activities requiring mental alertness until CNS effect are known. Advice patient to avoid taking large dose of vitamin C, it may cause kidney stone formation. Maintain a diet enhancing urine alkalinity, and if taking drug for calcium oxalate stones, reduce dairy products, refined sugar,
y
y
y
sodium and meat. y
Tell patient to stop drug and report if skin rash, stomatitis, malaise, and fever occur, this may precede hypersensitivity or adverse reaction.
