Advanced Oncology Certified Nurse Practitioner (AOCNP) Certification Practice Test

Which medication is used to prevent hyperuricemia in TLS?

1. Furosemide

2. Allopurinol

3. Mannitol

4. Rasburicase

The correct answer is: Allopurinol

The correct medication used to prevent hyperuricemia in tumor lysis syndrome (TLS) is allopurinol. Allopurinol is a xanthine oxidase inhibitor that works by reducing the production of uric acid, which is a byproduct of purine metabolism. During TLS, there is a rapid release of cellular contents into the bloodstream as tumors are broken down, leading to increased levels of uric acid. Allopurinol is effective in lowering uric acid levels and can help prevent the complications associated with hyperuricemia, such as acute kidney injury. Using allopurinol early in the management of patients at high risk for TLS can help mitigate the effects of massive cell lysis and reduce the incidence of hyperuricemia. It is typically administered as a preventive measure in patients undergoing chemotherapy for hematological malignancies. Other medications listed, such as furosemide, mannitol, and rasburicase, have different roles in the management of TLS. Furosemide is a diuretic that can help manage fluid overload but does not directly lower uric acid levels. Mannitol is used for osmotic diuresis and may help in acute kidney injury but again does not address uric