Reacciones adversas más frecuentes de los fármacos antirretrovirales

Introducción: las reacciones adversas a los antirretrovirales constituyen un obstáculo para el cumplimiento y la buena adherencia, debido a la gravedad que pueden alcanzar estos efectos, al abandono del tratamiento y/o remplazo del fármaco en cuestión. Objetivos: describir las reacciones a antirretrovirales más frecuentemente observadas. Pacientes y métodos: diseño observacional retrospectivo realizado en varones y mujeres, mayores de edad, portadores de HIV, que consultaron en el Servicio de Atención Integral del Hospital Nacional entre noviembre de 2007 y diciembre 2012. Resultados: fueron incluidos 190 pacientes, en 59 casos (31%) se presentaron efectos secundarios al TARGA. La edad media fue 35 años (rango 19-63 años). El 62,2% de los sujetos correspondían al sexo masculino. Predominaron las manifestaciones neuropsicológicas (28%), dermatológicas (22%) y hematológicas (21%).

Introduction: Adverse reactions to antiretroviral drugs are obstacles for the compliance and good adherence because of their severity, the treatment dropouts and/or the replacement of the drug. Objective: To describe the most frequently observed adverse reactions to antiretroviral drugs. Patients and methods: Retrospective observational design carried out in adult men and women, HIV carriers, who attended the Comprehensive Care Service between November, 2007 and December, 2012. Results: One hundred ninety patients were included and 59 cases (31%) presented side-effects to HAART. Mean age was 35 years (range: 19-63 years) and 62.2% of the subjects were men. Neuropsychological (28%), dermatologic (22%) and hematologic (21%) manifestations predominated.

Diagnóstico da busca de reações adversas a medicamentos nas diferentes fases da pesquisa clínica / A diagnosis on the search of drug adverse reactions in the different stages of clinical research

Com o aumento do número de reações adversas a medicamentos, faz-se necessária a monitorização adequada dos medicamentos durante seu desenvolvimento e após a comercialização, papel desempenhado pela farmacovigilância.

It was observed that none of the documents investigated dealt with the search for adverse reactions to drugs during all the stages of clinical research. Theauthors explored these reactions only in phase IV or pharmacovigilance.

Principales aspectos clínicos y epidemiológicos en pacientes con dermopatías por medicamentos / Main clinical and epidemiological aspects in patient with dermopathies due to drugs

Se realizó un estudio descriptivo y transversal de los 51 pacientes con dermopatías por medicamentos, ingresados en el Servicio de Dermatología del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, desde enero del 2011 hasta diciembre del 2012, para determinar las características clínicas y epidemiológicas de ellos. A tal fin se analizaron las variables: edad, sexo, cuadro clínico, fármacos ingeridos y vía de administración, persona que indicó el medicamento, entre otras. Las erupciones cutáneas por medicamentos se presentaron en una amplia variedad clínica, con predominio del eritema multiforme menor, el tratamiento fue indicado por facultativos en la mayoría de los casos, y entre los grupos de fármacos consumidos con más frecuencia figuraron los antimicrobianos y los analgésicos antiinflamatorios no esteroideos.

A descriptive, cross sectional and prospective study of the 51 patients with dermopathies due to drugs, admitted to the Dermatology Service of "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba was carried out from January, 2011 to December, 2012, to determine the clinical and epidemiological characteristics of them. For this purpose, the variables age, sex, clinical pattern, ingested drugs and administration route, person who indicated the drug, among others, were analyzed. The skin eruptions due to drugs were presented in a wide clinical variety, with prevalence of the minor multiform erythema, the treatment was indicated by doctors in most of the cases, and among the groups of consumed drugs with more frequency there were the antimicrobians and the non steroids analgesic anti-inflammatory drugs.

Reações adversas em pacientes com doença de Chagas tratados com benzonidazol, no Estado do Ceará / Adverse reactions in Chagas disease patients treated with benznidazole, in the State of Ceará

INTRODUÇÃO: A doença de Chagas, causada pelo Trypanosoma cruzi, é tratada com benzonidazol, tendo o inconveniente de apresentar efetividade parcial e alta toxicidade, que varia desde reações de hipersensibilidade a aplasia medular. O objetivo foi descrever e avaliar a ocorrência de reações adversas em pacientes chagásicos em tratamento com benzonidazol em Fortaleza, Ceará. MÉTODOS: Estudo descritivo prospectivo envolvendo 32 pacientes chagásicos crônicos tratados com benzonidazol entre janeiro de 2005 e abril de 2006. Dados sociodemográficos e clínicos foram coletados de questionários, entrevistas e exames laboratoriais. As amostras de sangue foram coletadas antes, com 30 e 60 dias de tratamento. RESULTADOS: Reações adversas foram relatadas em 28 (87,5 por cento) pacientes tratados, tendo sido as mais frequentes: prurido (50 por cento), formigamento (43,8 por cento), fraqueza muscular (37,5 por cento) e rash cutânea (31,3 por cento). Dos 28 pacientes com reações adversas, oito (28,57 por cento) interromperam o tratamento. Reações adversas que culminaram com a suspensão do tratamento foram formigamento sete (87,5 por cento) ou erupção cutânea cinco (62,5 por cento). Observou-se aumento discreto dos níveis de aminotransferases durante o tratamento em (9,4 por cento) pacientes. CONCLUSÕES: Concluindo, o acompanhamento farmacoterapêutico dos pacientes chagásicos é de grande relevância na prevenção e detecção precoce das reações adversas a medicamentos.

INTRODUCTION: Chagas disease is caused by Trypanosoma cruzi and treated with benznidazole (BNZ). This drug has the troublesome features of presenting partial effectiveness and high toxicity ranging from hypersensitivity reactions to medullary aplasia. The objective here was to describe and evaluate the occurrence of adverse reactions in Chagas disease patients treated with benznidazole in Fortaleza, Ceará. METHODS: This was a prospective descriptive study involving 32 chronic Chagas patients treated with benznidazole between January 2005 and April 2006. Sociodemographic and clinical data were collected through questionnaires, interviews and laboratory tests. Blood samples were collected before treatment and after 30 and 60 days of treatment. RESULTS: Adverse reactions were reported in 28 patients (87.5 percent) patients and the most frequent of these were pruritus (50 percent), prickling (43.8 percent), muscle weakness (37.5 percent) and skin rash (31.3 percent). Out of the 28 patients with adverse reactions, eight (28.57 percent) discontinued their treatment. The adverse reactions that culminated with discontinuation of the treatment were prickling (7; 87.5 percent) or skin eruptions (5; 62.5 percent). There was a slight increase in aminotransferase levels during the treatment in 9.4 percent of the patients. CONCLUSIONS: Following up the drug therapy administered to Chagas patients is of great importance for prevention and early detection of adverse reactions to drugs.