Zyloprim

Brand name: Zyloprim Generic name: Allopurinol Indications: to control primary hyperuricemia that accompanies severe gout and to prevent possibility of flare-up of acute gouty attack: to prevent recurrent calcium oxalate stones: prophylactically to reduce severity of hyperuricemia associated with antineoplastic and radiation therapies, both of which greatly increase plasma uric acid levels by promoting nucleic acid degradation. Drug classification: Antigout Agent Mechanism of action: allopurinol reduces endogenous uric acid by selectively inhibiting action of xanthine oxidase, the enzyme responsible for converting hypo-xanthine to xanthine and xanthine to uric acid (end product of purine catabolism). Has no analgesic, anti-inflammatory, or uricosuric action. Dosage: Treatment hyperuricemia Adult: PO 100mg/d, may increase by 100mg/wk (max: 800mg/d), divide doses >300mg/d. IV 200-400mg/m2/d (max: 600mg/d) in 1-4 divided doses Child: PO <10 y, 10mg/kg/d in 2-3 divided doses (max: 800mg/d) IV 200mg/m2/d in 1-4 divided doses. Treatment secondary hyperuricemia Adult: PO 200-800mg/d for 2-3 or longer, divide doses >300mg/d Child: PO 6-10 y, 100mg tid, <6 y, 50mg tid Renal impairment Clcr 80ml/min: 250mg/d ; 60ml/min: 200mg/d ; 40ml/min: 150mg/d ; 20ml/min: 100mg/d ; 10ml/min: 100mg q2d ; 0ml/min: 100mg q3d

Special precaution: impaired hepatic or renal function, history of peptic ulcer, lower GI tract disease, bone marrow depression. Pregnancy risk category: C Adverse reaction: CNS: drowsiness, headache, vertigo. GI: nausea, vomiting, diarrhea, abdominal discomfort, indigestion. HEMATOLOGIC: agranulocytosis, aplastic anemia, bone marrow depression, thrombocytopenia. SKIN: urticaria or pruritus, pruritic maculopapular rash, toxic epidermal necrolysis. OTHER: hepatotoxicity. Contraindication: hypersensitivity to allopurinol: as initial treatment for acute gouty attacks: idiopathic hemochromatosis (or those with family history): children (except those with hyperuricemia secondary to neoplastic disease and chemotherapy). Safety during pregnancy or lactation is not established. Form: 100 mg, 300 mg tablets: 500 mg vial Nursing responsibility: Monitor serum and urinary uric acid level usually by 1-3 weeks, gradual decrease in size of tophi, absence of new tophaceous deposits, with consequent relief of joint pain and increased joint mobility. Monitor for signs and symptoms of an acute gouty attack. Monitor patients with renal disorders more often; they tend to have a higher incidence of renal stones and drug toxicity problem. Report onset of rash or fever immediately to the physician; withdraw drug.