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Allopurinol is used to reduce urate formation in conditions where urate deposition has already occurred or is predictable. The specific diseases and conditions where it is used include gouty arthritis, skin tophi, kidney stones, idiopathic gout; uric acid lithiasis; acute uric acid nephropathy; neoplastic disease and myeloproliferative disease with high cell turnover rates, in which high urate ...
Hyperuricaemia or hyperuricemia is an abnormally high level of uric acid in the blood.In the pH conditions of body fluid, uric acid exists largely as urate, the ion form. [1] [2] Serum uric acid concentrations greater than 6 mg/dL for females, 7 mg/dL for males, and 5.5 mg/dL for youth (under 18 years old) are defined as hyperuricemia. [3]
Today, inflammation during attacks is more commonly treated with NSAIDs, colchicine, or corticosteroids, and urate levels are managed with allopurinol. [50] Allopurinol, which weakly inhibits xanthine oxidase, is an analog of hypoxanthine that is hydroxylated by xanthine oxidoreductase at the 2-position to give oxipurinol. [51]
Drugs with other primary uses, that have known uricosuric properties, include losartan, [1] atorvastatin, and fenofibrate.Although these drugs may have significant uricosuric action, their other significant pharmacological actions in off-label use as a uricosuric requires careful assessment of the patient to achieve the most benefit and least risk.
The picture of acute kidney failure is observed: decreased urine production and rapidly rising serum creatinine levels. Acute uric acid nephropathy is differentiated from other forms of acute kidney failure by the finding of a urine uric acid/creatinine ratio > 1 in a random urine sample.
Medications that may contribute to the cure or amelioration of hyperuricosuria include allopurinol which acts by inhibiting xanthine oxidase and reducing uric acid production. [2] Hyperuricosuria may be a medical sign of: Gout (very common) Kidney stones of uric acid (uric acid nephrolithiasis) Acute uric acid nephropathy; Acute kidney failure
However, there is tentative evidence that febuxostat may bring down urate levels more than allopurinol. [74] Probenecid appears to be less effective than allopurinol and is a second line agent. [20] [64] Probenecid may be used if undersecretion of uric acid is present (24-hour urine uric acid less than 800 mg). [75]
A tophus (Latin: "stone", pl.: tophi) is a deposit of monosodium urate crystals, in people with longstanding high levels of uric acid (urate) in the blood, a condition known as hyperuricemia. Tophi are pathognomonic for the disease gout. Most people with tophi have had previous attacks of acute arthritis, eventually leading to the formation of ...