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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Monitoramento de reaÃÃes adversas em pacientes chagÃsicos tratados com benzonidazol / Monitoring of adverse reactions in chagasic patients treated with benznidazole

Vania Maria Oliveira de Pontes 27 February 2007 (has links)
CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / INTRODUÃÃO: A doenÃa de Chagas, causada pelo protozoÃrio Trypanosoma cruzi, ainda representa uma das mais importantes doenÃas endÃmicas do continente Americano e tem sido diagnosticada desde o sul dos Estados Unidos atà o sul da Argentina. No Brasil, o benzonidazol à a Ãnica droga atualmente disponÃvel para o tratamento especÃfico desta enfermidade, porÃm a aplicaÃÃo clÃnica segura do benzonidazol demanda atenÃÃo por causar vÃrias reaÃÃes adversas, principalmente em pacientes adultos. OBJETIVO: Monitorar a ocorrÃncia de reaÃÃes adversas em pacientes chagÃsicos em tratamento com benzonidazol em Fortaleza - CearÃ. METODOLOGIA: Estudo descritivo longitudinal prospectivo de avaliaÃÃo da ocorrÃncia de reaÃÃes adversas durante o tratamento de pacientes chagÃsicos com benzonidazol. Foram incluÃdos no estudo, no perÃodo de 02 de janeiro de 2005 a 30 de junho de 2006, 32 pacientes chagÃsicos crÃnicos. Os dados foram coletados atravÃs de questionÃrio, entrevista e interpretaÃÃo de resultados de exames laboratoriais. As amostras de sangue foram coletadas antes, durante (30 dias) e ao final do tratamento com BZ (60 dias). Os exames laboratoriais foram bioquÃmicos (AST, ALT, urÃia e creatinina); hematolÃgicos (hemograma completo e contagem de plaquetas) e sorolÃgicos (ELISA). As suspeitas de ReaÃÃes Adversas a Medicamento (RAM) foram avaliadas pelo Centro de FarmacovigilÃncia do Cearà (CEFACE). Na anÃlise estatÃstica foi utilizado o programa SPSS 13 e realizado o teste t - Student considerando nÃvel de significÃncia p < 0,05. RESULTADOS: Foram registrados 20 sinais e sintomas por 28 (87,5%) pacientes. Os mais freqÃentes foram: prurido (57%), parestesia (46%) e cefalÃia (46%). A maioria das reaÃÃes foi classificada em relaÃÃo à causalidade como provÃvel (60,7%) e quanto à severidade como leve (73%). Dos 28 pacientes que apresentaram efeitos indesejÃveis durante o tratamento, 8 (29%) tiveram o tratamento suspenso e as reaÃÃes mais freqÃentes foram parestesia (87,5%) e rash cutÃneo (62,5%). A respeito dos resultados dos exames laboratoriais, a alteraÃÃo mais significativa foi eosinofilia em 6 (18%) pacientes. Embora nÃo significativo, houve um aumento expressivo dos valores das transaminases em 3 (9,4%) pacientes. ApÃs o tratamento, houve remissÃo dos sintomas e em relaÃÃo Ãs alteraÃÃes laboratoriais houve regressÃo dos valores aos nÃveis anteriores ao tratamento. CONCLUSÃO: As reaÃÃes adversas foram freqÃentes em pacientes tratados com benzonidazol. O farmacÃutico clÃnico pode ajudar os pacientes a lidar melhor com estes problemas, contribuindo para o sucesso dos resultados terapÃuticos. / INTRODUCTION: Chagasâ disease, caused by protozoan Trypanosoma cruzi, still represents one of the most important endemics diseases in American continent and has been diagnosed from south of United States to South of Argentina. In Brazil, benznidazole is the only drug currently available for specific treatment of this disease, but its safe clinical application demands attention for causing adverse reactions, mainly in adults patients. OBJECTIVE: To monitor the occurrence of adverse reactions in chagasic patients treated with benznidazole in Fortaleza, CearÃ. METHODOLOGY: Descriptive longitudinal prospective study of evaluation of adverse reactions occurrence during chagasic patient treatment with benznidazole. Thirty two chronics chagasic patients were included in the study since january of 2005 to june of 2006. Data were collected through questionnaire, interview and laboratorial exams results interpretation. Blood samples were collected before, during (30 days) and after treatment with benznidazole (60 days). Biochemical, hematological and serologic tests were made. The suspects Adverse Drug Reactions (ADR) were appraised for Cearà Pharmacovigilance Centre (CEFACE). In the statistical analysis were used the SPSS 13.0 and t - Student test, considering the significance level p < 0,05. RESULTS: Twenty signs and symptoms were recorded by 28 (87,5%) patients. The most frequent symptoms were: Pruritus (57%), paresthesia (46%) and headache (46%). Most of reactions were classified according to causality and severity as probable (60,7%) and slight (73%), respectively. Of the 28 patients that presented undesirable effects, 8 (29%) had treatment withdrew and the most frequent reactions were paresthesia (87,5%) and cutaneous rash (62,5%). In relation to laboratorial tests, the alteration most meaningful was eosinophylia in 6 (18%) patients. Although not significant, there was an expressive increase of the values of the transaminases levels in 3 (9,4%) patients. After treatment, the majority of symptoms and laboratorial tests results returned to the previous levels prior to medication. CONCLUSION: Adverse reactions are frequent in patients treated with benznidazole. Clinical pharmacists can help patients to deal with these problems contributing for better therapeutic results. Keywords: Chagas Disease â Therapy; Benzonidazole; Trypanosomicides - adverse effects.

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