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Sunday, May 25, 2008

Cancer Chemo and Allopurinol

A patient who is going to have chemotherapy and there is going to be a high cell turnover rate like in leukemia and lymphoma Allopurinol should be given as a prophylaxis for uric acid stones.
Allopurinol = prodrug converted by xanthine oxidase, forming alloxanthine which inhibits xanthine oxidase (suicide substrate). 

Inhibiting xanthine oxidase = decreases purine metabolism, which decreases uric acid which decreases uric acid stones. 

Allopurinol is used in gout.
It also inhibits the metabolism of 6-mercaptopurine raising its toxicity. 
Side effects = GI, peripheral neuropathy, rash, vasculitis and stone formation.

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