Pharmacology · patient case question
What is the mechanism of action of allopurinol?
Patient case: Polypharmacy — Cardiovascular & GI
demo: 68-year-old male
chief: “I need a crown on my lower left molar.”
history: Hypertension, gastroesophageal reflux disease, atrial fibrillation, hyperlipidemia, gout. Non-smoker.
meds: Lisinopril, omeprazole, verapamil, apixaban, rosuvastatin, allopurinol
findings: BP 132/84 mmHg. Generalized attrition. Tooth #19 with fractured MOD amalgam, no pulpal symptoms. No active periodontal disease.
Show answer and explanation
Correct answer: A. Inhibits xanthine oxidase, decreasing uric acid production
- A. Correct. Allopurinol blocks xanthine oxidase, the enzyme that converts hypoxanthine and xanthine to uric acid, so less urate is produced.
- B. Microtubule inhibition in leukocytes is colchicine, used for the acute gout attack.
- C. That is a uricosuric such as probenecid.
- D. Enzymatic conversion of urate to allantoin describes rasburicase/pegloticase.