[HSF] Allopurinol

[Sherman Turnage]

There was a paper in JCTVS in the early 90's that showed improved  
cardiac function in patients pre-treated with allopurinol. The  
mechanism is allopurinol is a potent inhibitor of xanthine oxidase,  
which is a key enzyme activated during ischemia that produces  
abundant oxygen free radical species during reperfusion. Inhibiting  
XO inhibited much (but not all) of the reperfusion injury to  
myocardium. Presumably, the drug would help inhibit oxygen free  
radical injury to other organs affected by malperfusion on CPB also.  
We incorporate allupurinol routinely in cardiac surgery patients at  
Flagler Hospital and several other hospitals in the Jacksonville  
area, Florida. Usual dose is 300 mg bid beginning evening before  
surgery and continuing through 1st pod. Will have to go on medline to  
see if I can find the original paper.

W. Sherman Turnage, MD
Vice President
Lighthouse Anesthesiology Consultants, PL
St. Augustine, FL