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Systemic review/ Meta analysis of allopurinol on blood pressure in stroke and ischaemic heart disease patients - Dissertation Example

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Allopurinol and hypertension Abbreviations ACS : Acute coronary syndrome ARF : Acute renal failure ATP : Adenosine Triphosphate BP : Blood pressure BNP : Brain natriuretic peptide CHF : Chronic heart failure CKD : Chronic kidney disease CRP : C-reactive protein CV : Cardiovascular CVA : Cerebrovascular accident CVD : Cardiovascular disease CRP : C-reactive protein DBP : Diastolic blood pressure DOCA : Desoxycortosterone acetate FMD : Fibro muscular dysplasia GFR : Glomerular filtration rate D HD : Haemodialysis HDL : High-density lipoprotein HF : Heart failure HTN : Hypertension HUA : High uric acid IHD : Ischemic heart disease I/R : Ischemia-reperfusion KT/V : Dialysis efficiency LVH : Left …
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Systemic review/ Meta analysis of allopurinol on blood pressure in stroke and ischaemic heart disease patients
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Download file to see previous pages Page No Abbreviations 1 Abstract 3 Chapter 1 Introduction 4 Chapter 2 Systematic Review 15 Chapter 3 Discussion and Conclusion 22 Appendix 28 References 44 Abstract This is a systematic review of the possible role of allopurinol in reducing blood pressure and whether it will emerge as a standalone future drug for reduction of blood pressure. The thirteen studies selected for the systematic review would show that allopurinol used for other conditions such as Hyperuricemia in patients suffering from kidney disease, cardiovascular disease, hypertension etc also had significant effect on reduction in blood pressure in the patients participated in the study. As there have been no promising results for significant reduction of BP even in hypertension and normotensive patients without any other disorders by administration of allopurinol , it is premature to conclude that this drug can be the sole drug for reducing BP. Allopurinol as an xanthine oxidase inhibitor can only be an adjunctive for having some mitigating effect on BP though it is a drug of choice of hyperuricemic patients. Chapter 1 Introduction 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 anaemia and formation of cataract (rare) and N, V, D. (Danish & Rabbani, 2010, p. 124). Allopurinol is a Xanthine oxidase inhibitor which decreases 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 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 ...Download file to see next pagesRead More
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