Adverse Effects of Multidrug Therapy For Leprosy: Use of Alternative Doses and Post Discharge Evaluation
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Hansenologia Internationalis (Online) |
Texto Completo: | https://periodicos.saude.sp.gov.br/hansenologia/article/view/35024 |
Resumo: | 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. |
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Adverse Effects of Multidrug Therapy For Leprosy: Use of Alternative Doses and Post Discharge Evaluation Efeitos adversos da poliquimioterapia para hanseníase: utilização de doses alternativas e avaliação pós altaHanseníaseMedicamentos ComplementaresToxicidade de DrogasPessoas com DeficiênciaLeprosyDrug CombinationsDrug ToxicityDisabled PeopleLeprosy 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.O tratamento da hanseníase pode causar efeitos adversos relacionados à Rifampicina (RMP) ou Dapsona (DDS) levando à mudança no esquema terapêutico. Objetivou-se determinar as causas da mudança do tratamento e avaliar as condições clínicas dermatológicas dos pacientes que fizeram uso da terapêutica alternativa. De 182 pacientes tratados entre 1997-2008, 34 (18,7%) fizeram doses alternativas e 21 foram entrevistados. O perfil foi constituído por casados, de 40 à 59 anos, baixa condição socioeconômica e escolaridade. Os pacientes paucibacilares (PB) e multibacilares (MB) sem o uso de DDS e de RMP tiveram as últimas baciloscopias (BAAR) negativas (>50%), e os resultados positivos dos outros mostrou involução lenta. A forma clínica mais incidente foi a virchowiana nos intolerantes à DDS, e a dimorfa nos sem a RMP. Os efeitos adversos acometeram mais os MB. Nos intolerantes à DDS, a mudança do esquema terapêutico foi relacionada às causas hematológicas (48,5%) e os à RMP, as hepáticas (50%). Na avaliação as placas e nódulos desapareceram. As manchas, dor geral ou localizada em membros, diminuição da sensibilidade e da força muscular com aparecimento de garra móvel foram significativas. A evolução das incapacidades revelou a necessidade de monitorar atentamente a função neural nos casos de alta.Instituto Lauro de Souza Lima da Secretaria de Estado da Saúde de São Paulo2014-06-30info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionAvaliado pelos paresapplication/pdfhttps://periodicos.saude.sp.gov.br/hansenologia/article/view/3502410.47878/hi.2014.v39.35024Hansenologia Internationalis: leprosy and other infectious diseases; Vol. 39 No. 1 (2014); 8-21Hansenologia Internationalis: hanseníase e outras doenças infecciosas; v. 39 n. 1 (2014); 8-211982-5161reponame:Hansenologia Internationalis (Online)instname:Instituto Lauro de Souza Lima (ILSL)instacron:ILSLporhttps://periodicos.saude.sp.gov.br/hansenologia/article/view/35024/33513Kubota, Rosina Maria MartinsBrancini, Viviane Cristina LGouveia, Aline SNardi, Susilene Maria TonelliPaschoal, Vania Del’ArcoVendramini, Silvia Helena Figueiredoinfo:eu-repo/semantics/openAccess2021-06-04T02:29:30Zoai:ojs.periodicos.saude.sp.gov.br:article/35024Revistahttps://periodicos.saude.sp.gov.br/hansenologiaPRIhttps://periodicos.saude.sp.gov.br/hansenologia/oaihansen_int@ilsl.br || hansenologia.internationalis@gmail.com || periodicossp@saude.sp.gov.br1982-51610100-3283opendoar:2021-06-04T02:29:30Hansenologia Internationalis (Online) - Instituto Lauro de Souza Lima (ILSL)false |
dc.title.none.fl_str_mv |
Adverse Effects of Multidrug Therapy For Leprosy: Use of Alternative Doses and Post Discharge Evaluation Efeitos adversos da poliquimioterapia para hanseníase: utilização de doses alternativas e avaliação pós alta |
title |
Adverse Effects of Multidrug Therapy For Leprosy: Use of Alternative Doses and Post Discharge Evaluation |
spellingShingle |
Adverse Effects of Multidrug Therapy For Leprosy: Use of Alternative Doses and Post Discharge Evaluation Kubota, Rosina Maria Martins Hanseníase Medicamentos Complementares Toxicidade de Drogas Pessoas com Deficiência Leprosy Drug Combinations Drug Toxicity Disabled People |
title_short |
Adverse Effects of Multidrug Therapy For Leprosy: Use of Alternative Doses and Post Discharge Evaluation |
title_full |
Adverse Effects of Multidrug Therapy For Leprosy: Use of Alternative Doses and Post Discharge Evaluation |
title_fullStr |
Adverse Effects of Multidrug Therapy For Leprosy: Use of Alternative Doses and Post Discharge Evaluation |
title_full_unstemmed |
Adverse Effects of Multidrug Therapy For Leprosy: Use of Alternative Doses and Post Discharge Evaluation |
title_sort |
Adverse Effects of Multidrug Therapy For Leprosy: Use of Alternative Doses and Post Discharge Evaluation |
author |
Kubota, Rosina Maria Martins |
author_facet |
Kubota, Rosina Maria Martins Brancini, Viviane Cristina L Gouveia, Aline S Nardi, Susilene Maria Tonelli Paschoal, Vania Del’Arco Vendramini, Silvia Helena Figueiredo |
author_role |
author |
author2 |
Brancini, Viviane Cristina L Gouveia, Aline S Nardi, Susilene Maria Tonelli Paschoal, Vania Del’Arco Vendramini, Silvia Helena Figueiredo |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Kubota, Rosina Maria Martins Brancini, Viviane Cristina L Gouveia, Aline S Nardi, Susilene Maria Tonelli Paschoal, Vania Del’Arco Vendramini, Silvia Helena Figueiredo |
dc.subject.por.fl_str_mv |
Hanseníase Medicamentos Complementares Toxicidade de Drogas Pessoas com Deficiência Leprosy Drug Combinations Drug Toxicity Disabled People |
topic |
Hanseníase Medicamentos Complementares Toxicidade de Drogas Pessoas com Deficiência Leprosy Drug Combinations Drug Toxicity Disabled People |
description |
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. |
publishDate |
2014 |
dc.date.none.fl_str_mv |
2014-06-30 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Avaliado pelos pares |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://periodicos.saude.sp.gov.br/hansenologia/article/view/35024 10.47878/hi.2014.v39.35024 |
url |
https://periodicos.saude.sp.gov.br/hansenologia/article/view/35024 |
identifier_str_mv |
10.47878/hi.2014.v39.35024 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://periodicos.saude.sp.gov.br/hansenologia/article/view/35024/33513 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Instituto Lauro de Souza Lima da Secretaria de Estado da Saúde de São Paulo |
publisher.none.fl_str_mv |
Instituto Lauro de Souza Lima da Secretaria de Estado da Saúde de São Paulo |
dc.source.none.fl_str_mv |
Hansenologia Internationalis: leprosy and other infectious diseases; Vol. 39 No. 1 (2014); 8-21 Hansenologia Internationalis: hanseníase e outras doenças infecciosas; v. 39 n. 1 (2014); 8-21 1982-5161 reponame:Hansenologia Internationalis (Online) instname:Instituto Lauro de Souza Lima (ILSL) instacron:ILSL |
instname_str |
Instituto Lauro de Souza Lima (ILSL) |
instacron_str |
ILSL |
institution |
ILSL |
reponame_str |
Hansenologia Internationalis (Online) |
collection |
Hansenologia Internationalis (Online) |
repository.name.fl_str_mv |
Hansenologia Internationalis (Online) - Instituto Lauro de Souza Lima (ILSL) |
repository.mail.fl_str_mv |
hansen_int@ilsl.br || hansenologia.internationalis@gmail.com || periodicossp@saude.sp.gov.br |
_version_ |
1796797578721886208 |