Determinación de las características e incidencia de reacciones adversas medicamentosas de tratamientos quimioterapéuticos y terapias dirigidas en paciente con neoplasias hematológicas del Hospital Del Salvador
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Archivos
Fecha
2023
Autores
Profesor/a Guía
Facultad/escuela
Idioma
es
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Universidad Andrés Bello
Nombre de Curso
Licencia CC
Licencia CC
Resumen
Las neoplasias hematológicas son uno de los tantos tipos de cáncer que usualmente
recibe tratamientos antineoplásicos, tales como las quimioterapias y las terapias
dirigidas, que debido a sus características farmacológicas son capaces de generar
un gran número de reacciones adversas medicamentosas (RAM), ya que, presentan
propiedades citotóxicas y/o son fármacos nuevos que se siguen evaluando los
efectos adversos que pueden generar. A nivel local se encuentra poca información
sobre cuáles serían las reacciones adversas que producen los antineoplásicos en la
población chilena; la literatura usualmente reporta las RAMs identificadas por el
proveedor de estos fármacos, que habitualmente se determinan en ambientes
controlados.
Dado a los antecedentes expuestos anteriormente, se llevó a cabo un estudio para
determinar las características e incidencias de las RAMs de quimioterapias y terapias
dirigidas en pacientes hematoncológicos del Hospital Del Salvador.
El estudio fue de tipo descriptivo observacional exploratorio y se realizó durante un
periodo de 5 meses, en donde a los pacientes seleccionados se les realizó un
seguimiento farmacológico durante todos los días que estuvieron hospitalizados con
el fin de identificar las RAMs. Se utilizó el algoritmo de Naranjo y Karch & Lasagna
para determinar la causalidad, y también se determinó la gravedad, órgano/tejido
afectado, incidencia y los factores de riesgo más prevalentes relacionados con la
aparición de la RAMs. Para determinar la gravedad y órgano/tejido afectado se
utilizaron los Common Terminology Criteria for Adverse Events (CTCAEv5.0) y para
el cálculo incidencia se tomó en cuenta la incidencia global y el riesgo por fármaco.
Se pesquisaron un total de 43 pacientes y se identificaron 150 RAMs, obteniendo
una incidencia global del 86,05% de pacientes con RAMs y una tasa de 4,05 RAMs
por paciente. Se determinó que las pacientes de sexo femenino, con edades entre 18
y 54 años, con comorbilidades, sin polifarmacia y con IMC entre 18,5-24,9
presentaron una mayor cantidad de RAMs. Las RAMs de tipo gastrointestinal, sangre
y sistema linfático, y de piel y tejido fueron las más frecuentes. Los grupos
farmacológicos que provocaron más RAMs fueron los antimetabolitos, agentes
alquilantes y las antraciclinas, siendo el metotrexato, citarabina, ciclofosfamida y
doxorrubicina los fármacos que más desarrollaron RAMs. La mayoría de las RAMs
visualizadas durante el estudio presentaron una gravedad de grado 1-2.
En conclusión, los pacientes con neoplasias hematológicas en tratamiento
antineoplásicos presentan una alta incidencia de desarrollar RAMs que afectan
principalmente a pacientes femeninas y a aquellos que presenten factores de riesgo
que aumentan la aparición de RAMs, en donde las RAMs de tipos gastrointestinal
son las más prevalentes, el grupo farmacológico de mayor riesgo de desarrollar
RAMs son los antimetabolitos como el metotrexato y la gravedad de las RAMs en su
mayoría son de grado 1 y 2.
Hematological neoplasms are one of the many types of cancer that typically receive antineoplastic treatments, such as chemotherapy and targeted therapies, which due to their pharmacological characteristics are capable of generating many adverse drug reactions (ADRs), as they possess cytotoxic properties and/or are new drugs that are still being evaluated for their potential side effects. Locally, there is limited information about the adverse reactions that antineoplastic drugs produce in the Chilean population; the literature usually reports ADRs identified by the provider of these drugs, which are commonly determined in controlled environments. Given the aforementioned background, a study was conducted to determine the characteristics and incidences of ADRs from chemotherapies and targeted therapies in hematological oncology patients at the Hospital Del Salvador. The study was of a descriptive observational exploratory type and was carried out over a period of 5 months, during which selected patients underwent pharmacological monitoring throughout their hospitalization to identify ADRs. The Naranjo and Karch & Lasagna algorithms were used to determine causality, and severity, affected organ/tissue, incidence, and the most prevalent risk factors related to the occurrence of ADRs were also determined. Common Terminology Criteria for Adverse Events (CTCAE v5.0) were used to determine severity and affected organ/tissue, and for calculating incidence, overall incidence and drug-specific risk were taken into account. A total of 43 patients were screened, and 150 ADRs were identified, resulting in an overall incidence of 86.05% of patients with ADRs and a rate of 4.05 ADRs per patient. It was determined that female patients aged between 18 and 54 years, with comorbidities, without polypharmacy, and with a BMI between 18.5-24.9, had a higher number of ADRs. Gastrointestinal, blood and lymphatic system, and skin and tissue ADRs were the most frequent. The pharmacological groups that caused the most ADRs were antimetabolites, alkylating agents, and anthracyclines, with methotrexate, cytarabine, cyclophosphamide, and doxorubicin being the drugs that most commonly led to ADRs. The majority of ADRs observed during the study had a severity of grade 1-2. In conclusion, patients with hematological neoplasms undergoing antineoplastic treatment have a high incidence of developing ADRs, mainly affecting female patients and those with risk factors that increase the occurrence of ADRs. Gastrointestinal type ADRs are the most prevalent, and the pharmacological group at the greatest risk of developing ADRs is antimetabolites like methotrexate, with the severity of ADRs mostly being grade 1 and 2.
Hematological neoplasms are one of the many types of cancer that typically receive antineoplastic treatments, such as chemotherapy and targeted therapies, which due to their pharmacological characteristics are capable of generating many adverse drug reactions (ADRs), as they possess cytotoxic properties and/or are new drugs that are still being evaluated for their potential side effects. Locally, there is limited information about the adverse reactions that antineoplastic drugs produce in the Chilean population; the literature usually reports ADRs identified by the provider of these drugs, which are commonly determined in controlled environments. Given the aforementioned background, a study was conducted to determine the characteristics and incidences of ADRs from chemotherapies and targeted therapies in hematological oncology patients at the Hospital Del Salvador. The study was of a descriptive observational exploratory type and was carried out over a period of 5 months, during which selected patients underwent pharmacological monitoring throughout their hospitalization to identify ADRs. The Naranjo and Karch & Lasagna algorithms were used to determine causality, and severity, affected organ/tissue, incidence, and the most prevalent risk factors related to the occurrence of ADRs were also determined. Common Terminology Criteria for Adverse Events (CTCAE v5.0) were used to determine severity and affected organ/tissue, and for calculating incidence, overall incidence and drug-specific risk were taken into account. A total of 43 patients were screened, and 150 ADRs were identified, resulting in an overall incidence of 86.05% of patients with ADRs and a rate of 4.05 ADRs per patient. It was determined that female patients aged between 18 and 54 years, with comorbidities, without polypharmacy, and with a BMI between 18.5-24.9, had a higher number of ADRs. Gastrointestinal, blood and lymphatic system, and skin and tissue ADRs were the most frequent. The pharmacological groups that caused the most ADRs were antimetabolites, alkylating agents, and anthracyclines, with methotrexate, cytarabine, cyclophosphamide, and doxorubicin being the drugs that most commonly led to ADRs. The majority of ADRs observed during the study had a severity of grade 1-2. In conclusion, patients with hematological neoplasms undergoing antineoplastic treatment have a high incidence of developing ADRs, mainly affecting female patients and those with risk factors that increase the occurrence of ADRs. Gastrointestinal type ADRs are the most prevalent, and the pharmacological group at the greatest risk of developing ADRs is antimetabolites like methotrexate, with the severity of ADRs mostly being grade 1 and 2.
Notas
Seminario (Químico Farmacéutico)
Palabras clave
Medicamentos, Efectos Adversos, Quimioterapia