American Association of Critical-Care Nurses (AACN) Certification Practice Test

What is the preventative medication for tumor lysis syndrome and gout attacks?

1. Probenecid

2. Allopurinol

3. Colchicine

4. NSAIDs

The correct answer is: Allopurinol

Allopurinol is the preventative medication used for tumor lysis syndrome and gout attacks due to its ability to inhibit xanthine oxidase, an enzyme involved in the conversion of hypoxanthine and xanthine to uric acid. By reducing uric acid production, it helps prevent the hyperuricemia that can occur after rapid cell turnover in conditions like tumor lysis syndrome or during gout flare-ups. In the context of tumor lysis syndrome, which can occur during cancer treatment or with the spontaneous breakdown of tumors, the rapid release of cellular contents leads to the production of large amounts of uric acid. Allopurinol helps to mitigate this risk by keeping uric acid levels within a manageable range. For gout attacks, allopurinol is utilized in a preventative capacity to reduce the frequency and severity of attacks by controlling uric acid levels in the blood. It is important to note that while other options like probenecid, colchicine, and NSAIDs may be relevant in the management of uric acid levels or gout, they serve different roles and are not primarily preventative medications. Probenecid, for example, works by increasing uric acid excretion but is not typically used for immediate prevention of acute attacks