Download File - the Drug Card Database

Gulf Coast Community College - Associate Degree Nursing
NUR 1260C – Gerontological Nursing
Medication Cards
Student Name:
Name of Drug:
Trade Name:
Allopurinol
Alloprim, Apo-Allopurinol, Lopurin, Zyloprim
Classification:
Xanthine oxidase inhibitors
Usual Adult Dose:
Initially 100mg/day ↑ at weekly intervals based on serum acid (not
to exceed 800 mg/day
Patient’s Dose:
Action:
Inhibits the production of uric acid by inhibiting the action of
xanthine oxidase
Adverse Effects:
Hypotension, flushing, hypertension, bradycardia, heart failure
(report w/IV administration), drowsiness, diarrhea, hepatitis, N/V,
renal failure, hematuria, rash (discontinue drug at 1st sign of rash),
urticaria, bone marrow depression, and hypersensitivity reactions.
Drug Interactions:
Use with mercaptopurine and azathioprine ↑ bone marrow
depressant properties--doses of these drugs should be ↓. Use with
ampicillin or amoxicillin ↑ risk of rash. Use with oral
hypoglycemic agents and warfarin ↑ effects of these drugs. Use
with thiazide diuretics or ACE inhibitors ↑ risk of hypersensitivity
reactions. Large doses of allopurinol may ↑ risk of theophylline
toxicity. May ↑ cyclosporine levels.
Nursing Implications:
Monitor intake and output ratios. Decreased kidney function can
cause drug accumulation and toxic effects. Ensure that patient
maintains adequate fluid intake (minimum 2500-3000 ml/day) to
minimize risk of kidney stone formation. Assess patient for rash or
more severe hypersensitivity reactions. Discontinue allopurinol
immediately if rash occurs. Therapy should be discontinued
permanently if reaction is severe. Therapy may be reinstated after a
mild reaction has subsided, at a lower dose (50 mg/day with very
gradual titration). If skin rash recurs, discontinue permanently.
Gout: Monitor for joint pain and swelling. Addition of
colchicine or NSAIDs may be necessary for acute attacks.
Prophylactic doses of colchicine or an NSAID should be
administered concurrently during the first 3-6 mo of therapy
because of an increased frequency of acute attacks of gouty
arthritis during early therapy.
Lab Considerations: Serum and urine uric acid levels usually begin to ↓ 2-3 days after
initiation of oral therapy. Monitor blood glucose in patients
receiving oral hypoglycemic agents. May cause hypoglycemia.
Monitor hematologic, renal, and liver function tests before and
periodically during therapy, especially during the first few months.
May cause ↑ serum alkaline phosphatase, bilirubin, AST, and ALT
levels. ↓ CBC and platelets may indicate bone marrow depression.
↑ BUN, serum creatinine, and CCr may indicate nephrotoxicity.
These are usually reversed with discontinuation of therapy.