Drug tocicity related to the use of Deoxycholate of Amphotericin b.

A Anfotericina B Desoxicolato (ANB-D) à uma droga que possui a capacidade de produzir muitos efeitos adversos. à uma substÃncia fungicida de escolha no tratamento da maioria das micoses sistÃmicas e uma alternativa importante para o tratamento da leishmaniose visceral. O Instituto de DoenÃas Tropicais Natan Portela à o Ãnico hospital de referÃncia para o tratamento de doenÃas infecciosas e parasitÃrias no Estado do PiauÃ. Participa da Rede Sentinela da ANVISA, e atravÃs do Sistema de FarmacovigilÃncia, monitora o uso dos fÃrmacos notificando qualquer reaÃÃo adversa a medicamentos (RAM). Partindo desse pressuposto, realizou-se este estudo, observacional, retrospectivo e quantitativo, a partir do qual foram analisados os prontuÃrios de todos os pacientes que utilizaram o fÃrmaco no perÃodo de janeiro a marÃo de 2009, um total de 60 pacientes, considerando sempre as reaÃÃes adversas a medicamentos, as queixas tÃcnicas e as interaÃÃes medicamentosas do fÃrmaco com outros medicamentos presentes nas prescriÃÃes mÃdicas. A anÃlise estatÃstica for realizadapelo programa Stata/SE 10.0 for Windows (CollegeStation, Texas, USA). Entre os pacientes analisados no presente estudo, 63,3% eram do sexo masculino. A faixa etÃria com maior nÃmero de pacientes foi a de â41 ou mais anosâ com 36%. A patologia presente na grande parte dos pacientes em uso de ANB-D foi a Leishmaniose visceral com 75,0%. 93,3% dos pacientes analisados apresentaram RAMs e 11,7% dos pacientes foram a Ãbitos, os quais apresentaram uma mÃdia de 5,6 RAMs/paciente. Evidenciou-se o maior numero de RAMs no grupo etÃrio de â21 à 40 anosâ. 6,0 RAMs/paciente foi o nÃmero mÃdio observado nos pacientes que nÃo receberam a prÃ-medicaÃÃo. Dentre as RAMs com maior freqÃÃncia estiveram: febre (76,7%), calafrios (45,0%), vÃmitos (40,0%), tosse (27,0%) e cefalÃia (25,0%). Observou-se que em um total de 221 RAMs, houve predominÃncia de RAMs de gravidade moderada (57%). Visualizou-se que nÃo houve interaÃÃo medicamentosa dos medicamentos prescritos quando utilizados em associaÃÃo à ANB-D. A maior letalidade ocorreu em pacientes com idade de 21 a 40 anos. Pacientes com AIDS tinham idade entre 21 e 40 anos principalmente. Conclui-se, portanto, que sÃo muitas as RAMs provocadas pela ANB-D. InformaÃÃes incompletas/ou ausentes sobre RAMs registradas nos prontuÃrios mostrou que pode existir subnotificaÃÃo dessas reaÃÃes. Dentre os grupos etÃrios, os que mais sofrem com o aparecimento dessas reaÃÃes sÃo adultos jovens (entre 21 e 40 anos).Acredita-se que, a maior freqÃÃncia de RAMs nos pacientes que vieram a Ãbito pode ter contribuÃdo para o agravamento do quadro clÃnico dos mesmos. Pacientes com AIDS tinham idade entre 21 e 40 anos principalmente, esta doenÃa pode ter sido a razÃo da maior letalidade.Amphotericin B Desoxicolate (AmB-D) is a drug that possesses the capacity to produce many adverse effects. It is a fungicide substance of choice in the treatment of the majority of the systemic mycosis and an important alternative for the treatment of visceral leishmaniosis. The institute of tropical diseases Natan Portela is the only hospital of reference for the treatment of parasite and infectious diseases in the state of PiauÃ. Participate of the sentinel web ANVISA, and through the farmacovigilance system, monitors the use of drugs notifying any adverse reaction to drugs. This observing, retrospective and quantitative study, was carried out in which the records of all the patients Who used the drug between january and march 2009, a total of 60 patients were analyzed, considering at all times adverse reactions to drugs, the technical complaints and the interactions of the drug with other drugs present in the medical prescription. The statistic analysis was carried out by the program Stata/SE 10.0 for Windows (College Station, Texas, USA). Among the patients analyzed in the present study, 63,3% were male. The age group with greater number of patients was â41 or overâ with 36%.The presnet pathology in most patients using AmB-D was visceral Leishmaniosis with 75,0%. 93,3% of the patients analyzed presented RAMs and 11,7% of the patients passed away. These patients presented an average of 5,6 RAMs/pacient. It was evident the greater number of RAMs in the age group from â21 to 40 yearsâ. 6,0 RAMs/pacient was the average number observed in the patients Who did not receive pre-medication. Among the RAMs with greater frequence were: fever (76,7%), chills (45,0%), vomit (40,0%), cough (27,0%) and headache (25,0%). It was observed that in a total of 221 RAMs, there was the predominance of RAMs of moderate seriousness (57%). It was observed that there was no drug interaction of the prescribed drugs when administered in association with AmB-D. Thegreater lethality happened in patients with age between 21 and 40 years. Patients with AIDS were aged between 21 and 40 years, mainly. It was concluded, therefore, that there are many RAMs caused by AmB-D. Incomplete or absent Information about RAMs registered in the records have shown that there may exist sub-notifications of these reactions. Among the age groups, the ones who suffers most with the appearing of these reactions are Young adults (between 21 and 40 years). It is believed that, the greater frequency of RAMs in the patients who passed away could have contributed for the worsening the clinical picture of these patients. Patients with AIDS were aged between 21 and 40 years mainly, this could have been the reason of greater lethality