Pain and Mobility
10.9 Antigout
Antigout medications are used to treat gout, a musculoskeletal disorder. Some antigout medications, such as colchicine, are classified as anti-inflammatory medications. Allopurinol is commonly used to prevent gout from recurring.
Allopurinol
Mechanism of Action
Allopurinol blocks the production of uric acid by inhibiting the action of xanthine oxidase.[1]
Indications for Use
Allopurinol is used for the prevention and treatment of gouty arthritis and nephropathy and for the treatment of secondary hyperuricemia.
Nursing Considerations Across the Lifespan
Allopurinol is safe for all ages. For clients with renal impairment, the dose will be reduced.
Adverse/Side Effects
Adverse effects include hypotension, flushing, hypertension, drowsiness, nausea and vomiting, diarrhea, hepatitis, renal failure, or a drug rash with eosinophilia and systemic symptoms (DRESS) syndrome or drug hypersensitivity syndrome.[2]
Client Teaching & Education
The medication should be taken as directed. An alkaline diet may be ordered for the client, and they may be advised to increase fluid intake to prevent kidney stone formation. The medication may cause dizziness or drowsiness. Clients who consume large amounts of alcohol may increase uric acid concentrations and decrease the effectiveness of the medication. If clients develop a rash or blood in the urine, this should be reported promptly to the healthcare provider.
Allopurinol Medication Card
Now let’s take a closer look at the medication card for allopurinol[3] Medication cards like this are intended to assist students to learn key points about each medication. Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication. Basic information related to each class of medication is outlined below. Prototype or generic medication examples are also hyperlinked to a free resource at Daily Med. On the home page, enter the drug name in the search bar to read more about the medication.
Medication Card 10.9.1: Allopurinol
Generic Name: allopurinol
Prototype/Brand Name: Purinol
Mechanism: blocks production of uric acid by inhibiting the action of xanthine oxidase
Therapeutic Effects
- Prophylaxis or treatment of gout
- Urine alkalinity
Administration
- Safe for all ages
- Reduce dose for renal impairment
- drink 2.5 to 3 L/day to decrease the risk of renal stone development.
- Take after meals.
Indications
- Treatment of gouty arthritis and nephropathy
- Treatment of secondary hyperuricemia
Contraindications
- Allergy to allopurinol, blood dyscrasias.
- Use cautiously with liver disease, renal failure, lactation, pregnancy
Side Effects
- Hypotension, flushing, hypertension, drowsiness, nausea and vomiting, diarrhea, hepatitis, renal failure, or a drug rash with eosinophilia and systemic symptoms (DRESS) syndrome or drug hypersensitivity syndrome.
- SAFETY: Discontinue drug at first sign of skin rash
Nursing Considerations
- Assess for allergies, and S&S of hyperuremia
- Take as directed.
- Reduce alcohol consumption.
- Regular blood tests.
- Alkaline diet and increased fluid – prevent kidney stone
- Report unusual bleeding, bruising, or rash to a health care provider immediately.
- Vallerand, A., & Sanoski, C. A. (2019). Davis’s Drug Guide for Nurses (16th ed.). F.A. Davis Company. ↵
- Cleveland Clinic. (2017, January 26). Acute v. chronic pain. https://my.clevelandclinic.org/health/articles/12051-acute-vs-chronic-pain. ↵
- This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain. ↵