QuestionSBA
QuestionChoice
Allopurinol is known to cause hepatic impairment, LFTs should be monitored every three months during the first year of taking allopurinol to monitor for this.
50186
a
LFTs every 3 months for the first year
QuestionChoice
Allopurinol is known to cause hepatic impairment, LFTs should be monitored every three months during the first year of taking allopurinol to monitor for this. An ultrasound of the liver would not be involved in the routine monitoring of allopurinol therapy.
50190
e
Ultrasound of liver at 6 months
QuestionChoice
Serum urate level is used in the first few weeks of allopurinol therapy in order to guide dosing, however, it would not be useful in monitoring the adverse effects of the drug.
50187
b
Serum urate levels monthly
QuestionChoice
Signs of gout may be able to be seen on X-ray, however, they are not routinely repeated in the long-term management of gout. X-ray findings of gout include tophi (soft tissue deposits of urate) and punched-out erosions.
50188
c
Repeat X-Ray of left toe in 6 months
QuestionChoice
Foods rich in purines such as offal, oily fish, game and red meat can increase the risk of gout. These should be avoided/reduced in the management of gout. Patients' diets are not routinely monitored. A healthy, balanced diet, rich in fruit and vegetables is encouraged.
50189
d
Food diary
QuestionComment
Where is this mentioned in the BNF?

39269
QuestionComment
Under Hepatic impairment - "Manufacturer advises monitor liver function periodically during early stages of therapy."
39587
User
subscriber
Amnesia Yeast
User
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Myopathy DNA
QuestionComment
yeah but replying to above comment its UNDER hepatic impairment AKA people who have liver problems to begin with - this man doesnt
61397
User
subscriber
Schistosomiasis
Concept
Chapter
Co-adminstration of allopurinol and azathioprine can lead to reduction in white blood cell count (pancytopenia) which can be very serious due to the high risk of infection. 

Allopurinol is a xanthine oxidase inhibitor used to treat chronic gout. 

Xanthine oxidase is an enzyme that is also a part of the pathway that breaks down Azathioprine. 

Without xanthine oxidase, azathioprine is broken down using a different pathway leading to accumulation of toxic metabolites that interfere with DNA synthesis and subsequent creation of white blood cells. Therefore, patients can present with pancytopenia, leading to higher risk of infection due to immunosuppresion.
1122
3615
Co-adminstration of allopurinol and azathioprine
Topic
9
Internal Medicine
10085
Case Presentation:  A 42-year-old man is due to be started on Allopurinol following a diagnosis of Gout in his left great toe. 


**PMH**

* Type 1 Diabetes
* Depression

**DH**

* Citalopram 40mg OD
* Humulin M3 12 units BD

Question: Which of the following is the most appropriate monitoring for the adverse effects of Allopurinol?
a