Avaliação dos parâmetros laboratoriais de pacientes chagásicos em uso de Benzonidazol atendidos por um serviço de atenção farmacêutica no estado do Ceará

Abstract

Chagas disease is a parasitic disease caused by the infectious agent Trypanosoma cruzi. In Brazil, the specific treatment for Chagas’ disease is carried out with benznidazole (Bz), the only drug available in the country. Benznidazole can lead to the onset of serious adverse reactions and in some cases may lead to the interruption of the treatment. Some of these reactions include laboratory parameter changes. This was a retrospective study that aimed to evaluate the hematological and biochemical laboratory parameters of Chagas patients during the use of benznidazole at the Pharmaceutical Care Service for the Chagas’ disease Patients of the Ceará state from January 2010 to December 2013. The analysis was performed through the following pharmacotherapeutic form and filed laboratory tests on the LPDC. The reading of the datas, provided by the treatment, was performed on days 0 (before), 30 (during) and 60 (after). The 60 patients evaluated in the study were characterized by being predominantly male (55.0%) with a mean age of 54.0 years, low income and education, mostly retired, farmer or housewife. The comorbidity rate was found to be 71.7% and hypertension was the most frequent. The medicines usage rate was 65.0% and cardiovascular drugs were the most frequent group. In relation to white blood cells, it was found that 4 (6.7%) of the 60 patients had leucopenia; 1 (1.7%) had neutropenia; 1 (1.7%) had lymphopenia; 5 (8.3%) had eosinopenia; 4 (6.7%) had eosinophilia and 3 (5.0%) had thrombocytopenia. As for the red blood cells, 5 (8.3%) patients presented red blood cells below the reference values; 2 (3.3%) had low hemoglobin; 4 (6.7%) had low hematocrit; 2 (3.3%) with low MCH; 5 (8.3%) had low MCHC. Regarding kidney function biochemistry, 4 (6.7%) showed altered urea values and 5 (8.3%) had altered serum creatinine levels. For the parameters of liver function, 3 (5.0%) presented changes in AST (SGOT) and 6 (10.0%) showed abnormal ALT (SGPT). However, it was observed that all laboratorial parameters were within the reference values when analyzed by mean and standard deviation for the three treatment fases. Changes in hematocrit, MCHC, lymphocytes and ALT were statistically significant. Thus, although considered rarer adverse reactions, laboratory findings are an important way of following Chagas’ patients in treatment with benznidazole, highlighting the importance of adequate orientation and monitoring by a qualified health professional.