Efeitos colaterais do uso da ribavirina, prednisona e DMSO em cães naturalmente infectados pelo vírus da cinomose / The side effects of ribavirin, prednisone and DMSO in dogs naturally infected by canine distemper virus

O estudo tem o objetivo de identificar efeitos indesejáveis da ribavirina, prednisona e DMSO em cães naturalmente infectados com o vírus da cinomose. Foram utilizados 60 cães apresentando quadro neurológico da cinomose com evolução de 10 dias. Os animais foram internados e receberam tratamento de suporte; foram avaliados diariamente e realizados hemograma, dosagem bioquímica e exame de urina tipo I. Os grupos 1 e 2 foram tratados com ribavirina e sua associação com DMSO; os grupos 3 e 4 com DMSO e prednisona e o grupos 5 com ribavirina e prednisona e o grupo 6 com ribavirina, prednisona e DMSO. Os animais foram anestesiados para a colheita de líquor, medula óssea e sangue, antes do tratamento para diagnóstico através da RT-PCR. As amostras negativas foram analisadas pela técnica de hn-PCR. Todos os animais apresentaram resultado positivo em pelo menos uma das duas reações. O efeito adverso da ribavirina e a sua associação com a prednisona foi a anemia hemolítica, que foi confirmada pela observação de bilirrubina na urina apenas dos cães tratados com ribavirina.

The present study aims at the identification of undesirable effects of ribavirin, predinisone and DMSO in dogs naturally infected by canine distemper virus. The research analyzed 60 dogs with clinical neurological signs and 10 days of evolution. The animals were hospitalized for the appropriate support treatment; were daily observed, and complete blood cells count, biochemical analysis, and urine exam type I were conducted. Groups 1 and 2 were treated with ribavirin and its combination with DMSO; Groups 3 and 4 treated with prednisone and DMSO, Group 5 treated with ribavirin and prednisone, while Group 6 with ribavirin, prednisone and DMSO. Before the treatment, animals were anesthetized for the cerebrospinal fluid, bone marrow and blood samples collection for the diagnosis based on RT-PCR. The negative samples were analyzed using the hn-PCR technique. All the animals presented positive results in at least one of the 2 tests. The adverse result of ribavirin and its association with prednisone was characterized by haemolytic anemia, confirmed by the evaluation of bilirrubin occurrence only in the urine of dogs treated with ribavirin.

La metoclopramida y sus reacciones adversas sobre el sistema nervioso central / The metoclopramide and its adverse reactions on the nervous central system

Introducción: la metoclopramida ha pasado a ser entre el año 2000 y 2006 el fármaco que con mayor frecuencia se asocia con las discinesias tardías atendidas. En un análisis realizado por Food and Drug Administration se advierte que el 20 por ciento de los pacientes a los que se les prescribe metoclopramida, la utilizan por de más de 3 meses. Objetivo: caracterizar las reacciones adversas a la metoclopramida reportadas y su relación con la notificación de discinesia tardía en nuestro país. Métodos: se realizó un estudio observacional, descriptivo, transversal de farmacovigilancia, que utilizó el método de notificación espontánea de reportes de reacciones adversas a medicamentos y la base de datos de la Unidad Coordinadora Nacional de Farmacovigilancia. Se analizaron todos los reportes de reacciones adversas medicamentosas desde el año 2003 a 2008 procedentes de todo el país. Resultados: se analizaron 1 119 notificaciones de reacciones adversas medicamentosas. Los sistemas de órganos más afectados fueron el sistema nervioso central (43,2 por ciento), seguido del aparato cardiovascular (14,2 por ciento). Predominaron las reacciones adversas medicamentosas probables (73,6 por ciento) y leves (51,7 por ciento), un 0,4 por ciento se correspondió con reacciones adversas graves, mientras que las más frecuentes fueron: extrapiramidalismo (29,0 por ciento), mareos (18,2 por ciento) y temblor (9,9 por ciento). La secuencia temporal entre la ocurrencia de la reacción adversa y la toma del medicamento que predominó fue en horas (53,8 por ciento). Conclusiones: se evidenció que la población pediátrica y geriátrica muestra mayor relación con el predominio de reacciones adversas a medicamentos del sistema nervioso central, no obstante la población adulta no debe quedar excluida, pues más de la mitad de las reacciones adversas a medicamentos del sistema nervioso central reportadas ocurrieron en este grupo de edad. Ese sistema fue el más afectado, aun sin estar relacionadas con dosis elevadas. Las discinesias reportadas pueden ser clasificadas como tempranas o agudas, y las reacciones adversas que predominaron fueron las leves y probables.

Introduction: metoclopramide from 2000 to 2006 years became the drug with higher frequency of association with late dyskinesia seen. In a analysis carried out by Food and Drug Administration (FDA) it is noticed that the 20 percent of patients with a prescription of metoclopramide use it drug for more than 3 months. Objective: to characterize the adverse reactions reported of metoclopramide and its relation to the notification of a late dyskinesia in our country. Methods: a cross-sectional, descriptive, observational study related to pharmacosurveillance using the method of spontaneous notification of reports on drug adverse reactions and the database of the National Coordination Unit of Pharmacosurveillance. Authors analyzed all reports of drug adverse react ions from 2003 to 2008 from all country. Results: a total of 1 119 notifications of drug adverse reactions. The organic system more involved were the central nervous system (43,2 percent) followed by the cardiovascular one (14,2 percent). There was predominance of probable drug adverse reactions (73,6 percent) and slights (51,7 percent), a 0,4 percent accounted for severe adverse reactions, whereas the more frequent were: extrapyramidal syndrome (29,0 percent), dizziness (18,2 percent) and shaking (9,9 percent). The predominant temporary sequence between the occurrence of adverse reaction and drug ingestion was in hours (53,8 percent). Conclusions: it was evidenced that children and elderly populations show a great relation with the predominance of drug adverse reactions of central nervous system, however, the adult population must not to be excluded, since more than a half of above mentioned reported reactions were in this age group. That system was the more involved even though there was not a link with high doses. The reported dyskinesias may be classified as early or acute and the adverse reactions predominant were the slight and probable ones.