Adverse Effects of Multidrug Therapy For Leprosy: Use of Alternative Doses and Post Discharge Evaluation

• Autor(a) principal: Kubota, Rosina Maria Martins
• Data de Publicação: 2014
• Outros Autores: Brancini, Viviane Cristina L, Gouveia, Aline S, Nardi, Susilene Maria Tonelli, Paschoal, Vania Del’Arco, Vendramini, Silvia Helena Figueiredo
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Hansenologia Internationalis (Online)
• Texto Completo: https://periodicos.saude.sp.gov.br/hansenologia/article/view/35024
• topic: Hanseníase; Medicamentos Complementares; Toxicidade de Drogas; Pessoas com Deficiência; Leprosy; Drug Combinations; Drug Toxicity; Disabled People

Leprosy treatment can cause adverse effects related to rifampin (RMP) or dapsone (DDS) leading to changes of the therapeutic regimen. The objective was to determine the causes of changes in the treatment and to evaluate the clinical dermatological conditions of patients who underwent alternative therapy. Out of 182 patients treated between 1997- 2008, 34 (18.7%) underwent alternative doses, and 21 were interviewed. The profile of the patients was: married, 40 to 59 years, low socioeconomic and educational status. The latest bacilloscopic index (BI) of paucibacillary (PB) and multibacillary (MB) patients that did not use DDS and RMP was negative (> 50%), and the positive results observed in the other patients evidenced slow recovery. The most frequent clinical form was lepromatous in patients intolerant to DDS and borderline leprosy in those without RMP. Adverse effects were most common in MB patients. Intolerance to DDS was related tohematological causes (48.5%), and intolerance to RMP was due to hepatic conditions (50%). Upon evaluation nodules and plaques disappeared. Plaques, general or localized pain in limbs, reduced sensitivity and muscular strength with the appearance of claw were significant findings. The development of disabilities revealed the need of careful monitoring of the neural function in cases discharged from treatment.