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Renal Disease; Fluid and Electrolyte Disorders
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Treatment involves reducing dietary purine intake (urate is a product of purine metabolism), and alkalinizing urine alkaline with sodium bicarbonate or potassium citrate. The drug allopurinol can be useful as it inhibits urate production.
Case 8
Published in Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta, Clinical Cases, 2021
Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta
For high-risk patients, oral allopurinol may also be givenThe dose varies from 100 to 900 mg daily, calculated according to their risk
Other Drugs Used to Treat Seizures
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
The most commonly reported adverse effects in epileptic patients receiving allopurinol have been nausea and vomiting, diarrhea, headaches, malaise, and insomnia (18,21). A toxic syndrome associated with hypersensitivity has been reported in patients with renal insufficiency (13). No teratogenic effects have been found in experimental animals (13).
Is the combination of linagliptin and allopurinol better prophylaxis against post-contrast acute kidney injury? A multicenter prospective randomized controlled study
Published in Renal Failure, 2023
Ahmed Fayed, Ahmed A. Hammad, Dina O. Abdulazim, Hany Hammad, Mohamed Amin, Samir Elhadidy, Mona M. Salem, Ibrahim M. Abd ElAzim, Lajos Zsom, Eva Csongradi, Karim M. Soliman, Usama A. Sharaf El Din
AKI is a common complication of radiocontrast exposure, especially in patients carrying underlying risk factors [1]. Among the non-modifiable risk factors, diabetes mellitus and CKD carry the highest risk [2]. The role of enhanced hypoxia and subsequent excess formation of reactive oxygen species (ROS) in the renal tissue following the administration of iodinated contrast media was demonstrated in many in vitro and in vivo studies [3]. A previous meta-analysis indicated that allopurinol might be an effective intervention compared with hydration and N-acetyl cysteine to prevent post-contrast AKI [4]. The preventive effect of allopurinol may be more remarkable in high-risk patients [5]. DPP4Is were not tried as preventive agents against post-contrast AKI. DPP4Is were found associated with a decreased risk of AKI among diabetic patients [6]. DPP4Is down-regulate the expression of the proinflammatory cytokines such as TNFα, IL-1β, IL-6, and chemokines such as MCP-1, hence; could be a potential mode of prevention of contrast-induced nephropathy [7].
Drug-induced Stevens-Johnson syndrome: a disproportionality analysis from the pharmacovigilance database of the World Health Organization
Published in Expert Opinion on Drug Safety, 2022
Yi Zheng, Wenli Zhou, Xiaojing Guo, Lijie Chi, Chenxin Chen, Zhijian Guo, Jizhou Liang, Lianhui Wei, Xiao Chen, Xiaofei Ye, Jia He
There were 3,062 reports in patients under 18, and 21,989 reports of patients over 18 with the 18–44 age group having the largest number of patients (N = 7,973), which suggests that SJS may be a disease more easily acquired by adults, especially for those who are 18 to 44. Carbamazepine showed a strong signal in all age groups, which was also the drug with the strongest signal value related to SJS among patients younger than 18. On the other hand, in the patients over 18, allopurinol was detected as the SJS-related drug with the strongest signal. Allopurinol is one of the most common drugs used in gout treatment. Gout has a predilection for adults, but rarely being observed in children. As a result, patients under 18 rarely use allopurinol, which also accordant with the result in the <18 subgroup that allopurinol failed to show positive signal value.
What’s new on the front-line of gout pharmacotherapy?
Published in Expert Opinion on Pharmacotherapy, 2022
Kurt E. G. Blake, Jordan L. Saag, Kenneth G Saag
Lesinurad is a novel inhibitor of URAT1 and an organic anion transporter (OAT) four in the nephron. RCTs have demonstrated greater efficacy with urate reduction when it is added to XO inhibitors compared to XO inhibitors alone. Combining Lesinurad with Allopurinol Standard of Care in Inadequate Responders (CLEAR) 1 study randomized 603 patients to Lesinurad 200 mg, 400 mg and placebo groups. All patients received allopurinol as standard of care. There was a significant reduction in serum urate levels < 6 mg/dl for Lesinurad 200 mg + allopurinol (54%), Lesinurad 400 mg + allopurinol (59%) vs allopurinol only (28%), p < 0.0001. There were no significant cardiovascular or renal safety signals [76]. Similar efficacy results were noted in the similarly designed multinational CLEAR-2 trial. It was noted that a greater number of patients treated with lesinurad had reversible elevation of creatinine ≥ 1.5 × baseline compared to patients receiving allopurinol monotherapy [77]. These renal events were likely related to the microcrystalization of urate in kidney tubules.