Tolerabilidad local de bruprenorfina T.D.S. tras la administración profiláctica de antihistamínicos antagonistas H1
2007; Q106299148; Volume: 14; Issue: 7 Linguagem: Inglês
ISSN
2254-6189
AutoresR. Escartín Villacampa, P. Aguado, Christopher M. Bono, Dolores Rodrigo, J Quero, P. Cía,
Tópico(s)Drug-Induced Adverse Reactions
ResumoespanolIntroduccion: Uno de los efectos secundarios de la buprenorfina T.D.S, en un porcentaje importante de pacientes, es su mala tolerabilidad local. Objetivos: Evaluar la tolerabilidad local de buprenorfina T.D.S., tras la administracion profilactica de antihistaminicos antagonistas H1 por via oral durante el primer mes de tratamiento y posteriormente por via topica, si persistia la irritacion local. Asi como su efectividad en el tiempo. Material y Metodo: Se ha realizado un estudio observacional prospectivo de 80 pacientes (60 mujeres y 20 varones), edad media 65,08 +/- 13,5 anos (R 34 - 87), que presentaban dolor cronico osteoarticular de intensidad moderada. Seguimiento: 6 meses. Controles: visita basal, 1, 2, 3 y 6 meses. Dosis: buprenorfina T.D.S. entre 17,5 y 70 µg/h cada 3 dias. Dosis media 37,84 +/- 16,34 µg/h. Todos los pacientes comenzaron tratamiento simultaneo con cetirizina via oral 10 mg/dia en dosis unica nocturna durante un mes. A partir del mes, dimetindeno gel en aquellos pacientes con persistencia de exantema, eritema o prurito, al suspender la via oral. Se valoro como: 1. Tolerabilidad local buena solo con via oral: aquellos pacientes que no presentaron ninguna reaccion adversa local tras el mes de tratamiento oral y siguen igual a los 6 meses. 2. Tolerabilidad local buena con via oral + via topica: aquellos pacientes que tras suspender la via oral al mes, persistia reaccion adversa local y tras la administracion via topica no presentaron reacciones adversas locales y siguen igual a los 6 meses. 3. Tolerabilidad local regular con via oral + via topica: aquellos pacientes que tras suspender la via oral al mes, persistia reaccion adversa local y tras la administracion via topica han seguido con eritema y prurito leve y tolerable a los 6 meses. 4. Tolerabilidad local mala solo con via oral: aquellos pacientes que tras el mes de tratamiento oral presentaron eritema y prurito severo y tuvieron que suspender el tratamiento con buprenorfina T.D.S. 5. Tolerabilidad local mala con via oral + via topica: aquellos pacientes que tras suspender la via oral al mes, persistia eritema y prurito y tras la administracion via topica no remitio la reaccion adversa, suspendiendo buprenorfina T.D.S. Resultados: BUENO: 56 pacientes (70%) via oral solo y via oral + topica. REGULAR: 7 pacientes (8,75%) via oral + topica. MALO: 17 pacientes (21,25%) via oral y via oral + topica, se suspende tratamiento. Conclusiones: Los resultados han sido buenos sin reaccion adversa local y persistiendo en el tiempo en un alto porcentaje de los pacientes al seguir con la via topica tras el primer mes de la via oral. No ha presentado ningun paciente tumefaccion local ni reaccion alergica. Con la utilizacion de dimentideno no se ha observado alteracion en la liberacion del farmaco ni disminucion en su efecto analgesico. EnglishIntroduction: One of the side effects of buprenorphine T.D.S, in an important percentage of patients, with bad local tolerability. Objetives: To evaluate the local tolerability of buprenorphine T.D.S., after the prophylactic administration of antihistamine Hl antagonists orally during the first month of treatment and after using topical therapy if the local irritation persisted. As well as its effectiveness along the time. Material and Method: A prospective observational study of 80 patients have been made (60 women and 20 men), age mediates 65.08 ±13.5 years (R 34-87), with osteoarticular chronic pain of moderate intensity. We checked the following 6 months. Controls: basal, 1, 2, 3 and 6 months. Dose: buprenorphine T.D.S between 17.5 and 70 µg/h every 3 days. doses mediate 37.84 ± 16.34 µg/h. All the patients began simultaneous treatment with cetirizina 10 mg/day orally in nocturnal unique dose during one month. Since them, we administered dimetindeno gel in those patients with persistence of exanthema, erythema or pruritus, when They stopped orally. It was valued like: 1. Good local tolerability only with orally: those patients who had not any local adverse reaction after one month of orally treatment and continue similar 6 months later. 2. Good local tolerability with orally + topical theraphy: those patients whom after suspending orally one month later, local adverse reaction persisted and after the topical theraphy administration, had not any local adverse reactions and continue similar 6 months later. 3. Regular local tolerability with orally + topical theraphy: those patients whom after suspending orally one month later, local adverse reaction persisted and after the topical teraphy administration had continued with slight and tolerable erythema and pruritus 6 months later. 4. Bad local tolerability only with orally: those patients whom after one month with orally treatment had severe erythema and pruritus and they had stopped treatment with buprenorphine T.D.S. 5. Bad local tolerability orally + topical theraphy: those patients whom after suspending orally one month later, persisted erythema and pruritus and after topical theraphy administration did not send the reaction adverse, stopping buprenorphine T.D.S. Results: GOOD: 56 patients (70%) orally only and orally + topical theraphy. FAIR: 7 patients (8.75%) orally + topical theraphy. BAD: 17 patients (21.25%) orally and orally + topical theraphy, they had suspended treatment. Conclusions: The results were good without local adverse reaction and persisting in the time in a high percentage of the patients following with the topical theraphy after one month orally. It had not any patient with local tumidity neither allergic reaction. It had not observed any variation of analgesic efficacy, so that, it had not changed of drug liberation because the previous topical theraphy of dimetindeno.
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