Reducing Blood Pressure: Allopurinol and Hypertension - Dissertation Example

Allopurinol is used in the treatment of Primary and secondary hyperuricemia, Chronic gout; chronic tophaceous gout; gouty nephropathy, Prevention of deposition of urate crystals in tissues, and occurrence of urate renal stones, and As an antiprotozoal agent. It is also used in patients allergic or intolerant to probenecid and sulfinpyrazone.
Some of the drug’s side effects are exacerbation of an acute attack of gouty arthritis. To avoid these attacks colchicine and Indomethacin are administered before commencing allopurinol therapy. Hypersensitivity reactions such as pruritic maculopapular lesions and exfoliative dermatitis. Peripheral neuritis. Necrotising vasculitis. Bone marrow suppression. Aplastic anemia and formation of cataract (rare) and N, V, D. (Danish & Rabbani, 2010, p. 124).

Allopurinol is a Xanthine oxidase inhibitor that decreases the synthesis of uric acid In oral administration, Allopurinol is approximately absorbed by 80% with a terminal serum t1/2 of 1-2 hours. Allopurinol is a pro-drug and is metabolized by Xanthine oxidase enzyme to alloxanthine which in turn inhibits Xanthine oxidase enzyme and thus inhibits the uric acid synthesis and increases the concentrations of hypoxanthine and Xanthine. Since Alloxanthine is long-acting, Allopurinol should be given once daily (Danish & Rabbani, 2010, p. 60).

Xanthine oxidase is the catalyzing enzyme that catalyzes the oxidation of hypoxanthine to xanthine and can further catalyze the oxidation of xanthine to uric acid.. (Danish & Rabbani, 2010, p. 5).

Hypertension
Hyperuricemia is a risk factor for vascular disorders such as hypertension, cardiovascular disease, cerebrovascular disease (Terkeltaub, 2011, p. 157). Hypertension and hyperuricemia generally coexist. People with hypertension of various degrees have hyperuricemia. 40 % of people with gout have hypertension. While hyperuricemia has its own contribution to hypertension, medications used in the course of treatment of hypertension also aggravate the condition. Allopurinol can reduce blood pressure in patients with hyperuricemia. A study on 48 patients who were administered 300 mg of the drug/day for 3 months showed it could reduce systolic and diastolic blood pressure. In yet another study on 30 adolescents of age 11 to 17 years having hypertension, it was found that 200 mg of Allopurinol twice daily for two weeks could greatly reduce blood pressure in them. However, no such studies have been done on patients with gout (Terkeltaub, 2011, p. 160).

Thus, Allopurinol originally not an antihypertensive medication is now found to be lowering blood pressure which would confirm that uric acid has a role in the development of hypertension. With the risk profile of allopurinol, caution should be exercised in advocating a uric acid reduction in the treatment of hypertension (Kaplan, 2010, p. 446).