Rasburicase is used in the treatment of which condition? (LQ)
|D||Churg Strauss disease|
Treatment (Ref: H-18th edition, Pg-2838)
A. Acute attack
i. NSAID usually indomethacin. But aspirin is contraindicated because it raises the uric acid level.
ii. Colchicine: it inhibits granulocyte migration but can cause diarrhea
Allopurinol: It is a xanthine oxidase inhibitor
Extra Edge:: Allopurinol is not used in a acute attack
C: Uricosuricdrugs :Probenecid, sulphinpyrazone.
Recent Advances: Losartan, fenofibrate, and amlodipine have some mild uricosuric effects.
Recent Advances - New Drugs (Ref: H-18th edition, Pg-2838)
1. Febuxostat =Xanthine oxidase inhibitor drug
2. Benzbromarone It is new uricosuric drug
3. Rasburicase: It converts purine to allantois which is a water soluble compound.
Basic Biochemistry: Purin pathway. Allopurinol blocks the conversion of xanthine to uric acid. The urate oxidase rasburicase catalyses the oxidation of uric acid to allantoin, a highly water-soluble metabolite readily excreted
by the kidney
Extra Edge: All the diuretics are contraindicated in Gout because they cause hyperuricemia.
The only diuretic which has uricosuric effects so can be given in Gout is TIENELIC ACID!!!
Extra Edge: Pharmacotherapy
a. Modulation of purine metabolism has pharmacotherapeutic value.
b. Purine synthesis inhibitors inhibit the proliferation of cells, especially leukocytes.
c. The inhibitors are
ii. Mycophenolatemofetil is an immunosuppressant drug used to prevent rejection in organ transplantation; it inhibits purine synthesis by blocking inositol monophsophate dehydrogenase.
iv. Allopurinol is a drug that inhibits the enzyme xanthine oxidase and, thus, lowers the level of uric acid in the body. So it is useful in the treatment of gout.