RESUMO
BACKGROUND: Taxanes adjuvant therapy is recommended in certain high risk or metastatic tumors, particularly in lung and breast cancer, but also in other types of cancer like ovarian. The incidence of severe adverse drug reactions to paclitaxel is of approximately 10%. OBJECTIVES: Analyze type I hypersensitivity reactions to paclitaxel and their management in the Mexican population. METHOD: It is a retrospective, observational and descriptive study that included type I hypersensitivity reactions to paclitaxel reported from our database. Symptoms of hypersensitivity reactions to paclitaxel were classified and skin testing was performed with a 6 mg/mL paclitaxel concentration. The desensitization procedure consisted of a 12-steps, 3-bags of 250 mL protocol with a 6-7-hour duration. RESULTS: A total of 60 desensitization procedures were performed and were all completed successfully. All participants in our group were female, their median age was 44.5 years.All of our patients had hypersensitivity adverse drug reaction to paclitaxel during their first exposure and within the first 10 minutes of infusion. 63.6% of the patients had a moderate hypersensitivity reaction to paclitaxel and 36.4% had a severe reaction. CONCLUSIONS: Paclitaxel continues to be a common use drug and has a high rate of adverse drug reactions. This is the first study of hypersensitivity to paclitaxel in a Mexican population.
Assuntos
Neoplasias da Mama , Hipersensibilidade a Drogas , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Hipersensibilidade Imediata , Adulto , Neoplasias da Mama/complicações , Dessensibilização Imunológica/métodos , Hipersensibilidade a Drogas/etiologia , Hipersensibilidade a Drogas/terapia , Feminino , Humanos , Hipersensibilidade Imediata/induzido quimicamente , Hipersensibilidade Imediata/complicações , Masculino , Paclitaxel/efeitos adversos , Estudos RetrospectivosRESUMO
Rhinitis is the most frequent respiratory disease in most countries of the world. It is estimated that 600 million people suffer this condition. Allergic rhinitis is a public health problem at global level. Patients who suffer allergic rhinitis have from mild to annoying nasal symptoms which affect quality of life, cause sleep disorders, scholar and workplace absenteeism, and health expenditure. Rhinitis is frequently associated to co-morbidities such as sinusitis, otitis media, and especially asthma. Rhinitis is under-diagnosed and under-treated worldwide and also in Latin American countries. ARIA is the very first evidence-based guideline for the diagnosis and treatment of rhinitis with focus in its co-morbidities (2001), especially asthma published in 2001. In 2008 an update was published. ARIA recommends an integrative approach for management; including anti-histamines (second generation), intra-nasal corticosteroids, anti-leukotrienes and immunotherapy. It also provides a questionnaire to evaluate asthma and its severity in those patients suffering rhinitis. The prevalence of allergic rhinitis is quite high in Latin American countries and in recent years a great insight on the burden of this condition has been gained.