On today's episode of real-life pharmacology, we are going to talk about allopurinol,

and a little bit less specific in general, the Xanthine oxidase inhibitors.

As far as the pharmacology goes with these medications,

it's important to remember that Xanthine oxidase is an enzyme that

basically helps the body promote, create uric acid, or it's in that pathway anyway. So by

inhibiting xanthine oxidase, we can therefore reduce uric acid.

Uric acid is really a problem in gout.

As uric acid levels increase, we have the risk of formation of gout flares.

Primarily, the classic case there is where a patient has extreme pain in the great toe, the big toe,

that can be really, really troublesome for patients.

So allopurinol and fibuxat, which is brand name Uylarc.

Brand name for alipurinol is xyloprim.

Those actually reduce uric acid and help prevent gout flares.

Now when I talk about prevention of gout flares,

it's really important to know the difference between prevention and between treatment.

Okay, because allopurinol only prevents gall flare.

So if you have a patient presenting to your care with extreme pain, that type of thing,

giving them, prescribing them, if they've got a prescription for allopurinol,

that's not going to solve the acute pain of the acute gout flare.

Very, very important to remember that.

For acute flares, we use medications like inseds and prednisone, possibly colchazine as well.

So very, very important to remember that allopurinol will not treat that acute gout flare.

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