10.9 Antigout
Open Resources for Nursing (Open RN)
Antigout medications are used to treat gout, a musculoskeletal disorder. Some antigout medications, such as colchicine, are classified as anti-inflammatory medication. 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 patients 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]
Patient Teaching & Education
The medication should be taken as directed. An alkaline diet may be ordered for the patient, and they may be advised to increase fluid intake to prevent kidney stone formation. The medication may cause dizziness or drowsiness. Patients who consume large amounts of alcohol may increase uric acid concentrations and decrease the effectiveness of the medication. If patients develop a rash or blood in the urine, this should be reported promptly to the healthcare provider.[3]
Now let’s take a closer look at the medication grid on allopurinol in Table 10.9.[4],[5],[6]
Table 10.9 Allopurinol Medication Grid
| Class/
Subclass |
Prototype-
generic |
Administration Considerations | Therapeutic Effects | Adverse/Side Effects |
|---|---|---|---|---|
| Antigout agent | allopurinol | May be given with milk or meals to decrease stomach upset
Give with plenty of water May be crushed Monitor patient’s intake and output Monitor hematologic, renal, and liver functions before and during therapy If rash occurs, notify healthcare provider |
Prevention and treatment of attacks of gouty arthritis and nephropathy
Treatment of secondary hyperuricemia |
Hypotension
Flushing Hypertension Drowsiness Nausea and vomiting Diarrhea Hepatitis Rash Renal failure |
- 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. ↵
- uCentral from Unbound Medicine. https://www.unboundmedicine.com/ucentral ↵
- Frandsen, G., & Pennington, S. (2018). Abrams’ clinical drug: Rationales for nursing practice (11th ed.). pg. 305, 310, 952-953, 959-960. Wolters Kluwer. ↵
- Vallerand, A., & Sanoski, C. A. (2019). Davis’s Drug Guide for Nurses (16th ed.). F.A. Davis Company. ↵
- Centers for Disease Control and Prevention. (2019, August 28). Opioid overdose, CDC guideline for prescribing opioids for chronic pain. https://www.cdc.gov/drugoverdose/prescribing/guideline.html. ↵
