Dillman Kathryn M, Hawkins Alison M, Ragland Amanda R, Wester Grace C, Greene Driskell R, Varrassi Giustino, Moore Peyton, Behara Raju, Ahmadzadeh Shahab, Siddaiah Harish, Shekoohi Sahar, Kaye Alan D
Medicine, Louisiana State University Health Sciences Center New Orleans, New Orleans, USA.
Medicine, Louisiana State University Health Sciences Center, Shreveport, USA.
Cureus. 2024 Jul 16;16(7):e64654. doi: 10.7759/cureus.64654. eCollection 2024 Jul.
Allopurinol lowers urate production through the inhibition of xanthine oxidase. It is oxidatively hydroxylated to oxypurinol and is the most prescribed medication for gout treatment. Although it has a beneficial effect in the treatment of this common disease, like many medications, it is also known for having numerous adverse effects. Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), diseases that exist on a spectrum, are two of the most dangerous adverse effects associated with allopurinol use. These immune-mediated disease processes involve almost every organ system. They are essential to recognize as early as possible, as they could potentially be deadly, requiring cessation of the medication with initial signs of rash or other early manifestations of SJS/TEN. One major consideration in the increased risk of allopurinol-mediated or modulated SJS/TEN is the need to have a lower dose in the setting of renal disease. The purpose of this review is not only to examine the involvement of allopurinol in SJS/TEN but also to provide detailed information about the drug, allopurinol, and general features and characteristics of SJS/TEN and other associated drug reactions.
别嘌醇通过抑制黄嘌呤氧化酶降低尿酸生成。它经氧化羟基化生成氧嘌呤醇，是治疗痛风最常用的药物。尽管它对这种常见疾病的治疗有有益作用，但与许多药物一样，它也因有众多不良反应而闻名。史蒂文斯 - 约翰逊综合征（SJS）和中毒性表皮坏死松解症（TEN）是存在于一个连续谱上的疾病，是与使用别嘌醇相关的两种最危险的不良反应。这些免疫介导的疾病过程几乎涉及每个器官系统。尽早识别它们至关重要，因为它们可能是致命的，一旦出现皮疹的初始迹象或SJS/TEN的其他早期表现，就需要停用该药物。别嘌醇介导或诱发SJS/TEN风险增加的一个主要考虑因素是在肾病情况下需要使用较低剂量。本综述的目的不仅是研究别嘌醇与SJS/TEN的关联，还提供有关药物别嘌醇的详细信息，以及SJS/TEN和其他相关药物反应的一般特征。
