Profile of immediate adverse reactions to chemotherapy infusion in outpatients at a University Hospital in the state of Rio de Janeiro
DOI:
https://doi.org/10.33448/rsd-v10i15.23009Keywords:
Chemotherapy; Adverse events; Pharmacovigilance; Patient safety.Abstract
Most antineoplastic agents can cause infusion reactions, the incidence and profile of which vary according to the characteristics of each drug, which may or may not be immune-mediated. In order to describe the profile of immediate adverse reactions to chemotherapy infusion in outpatients, we developed this exploratory, descriptive, cross-sectional and retrospective study, based on records of adverse reaction notifications carried out by the multidisciplinary team from March/2018 to March/2019, and the medical records of the participants. Adverse reactions immediate to chemotherapy infusion were ranked for severity according to the Common Terminology Criteria for Adverse Events and for causality using Naranjo's algorithm. Of a total of 6,832 intravenous chemotherapy facilities performed during the study period, 30 immediate adverse reactions were recorded, involving 28 patients (83% women), mainly with Paclitaxel (44%) and Carboplatin (20%). According to Naranjo, 60% of infusion reactions were classified as probable. The mean time for onset of reactions was 40 minutes, being the fastest with Docetaxel (5 minutes) and the longest with Paclitaxel (180 minutes). The severity of reactions ranged from mild (64%) to moderate (30%). The most compromised organic segments were respiratory (27%) and cardiovascular (26%); and 83% of the symptoms presented were predicted in the databases. With this study, it was possible to identify the main immediate reactions to the infusion in the study group, as well as the chemotherapeutic agents involved with them, contributing to the safe management of patients and effective control of reactions by the multidisciplinary team.
References
Ayub, M. N., da Silva, D., Martinbiancho, J. K., & Dal-Pizzol, T. S. (2010). Adverse Drug Reactions in Patients Hospitalized in the Intensive Care Unit of a University Hospital in Southern Brazil. Am. J. Pharm, 29(5), 688–693.
Bertolazzi, L. G., Lanza, M. V. de C., Bitencourt, E. C., Canille, R. M. da S., Pereira, L. P. de S., Oliveira, K. A. de, & Fernandez, F. L. C. (2015). INCIDÊNCIA E CARACTERIZAÇÃO DE REAÇÕES ADVERSAS IMEDIATAS À INFUSÃO DE QUIMIOTERÁPICOS EM HOSPITAL SENTINELA. Arquivos de Ciências Da Saúde, 22(3), 84–90. https://doi.org/10.17696/2318-3691.22.3.2015.107.
Borges, M. da S., Salles, M.M., & Camuzi, R.C. (2021). Incidência e caracterização das reações adversas imediatas e tardias à infusão de quimioterapia em pacientes ambulatoriais de um hospital sentinela. Trabalho de Pós-Graduação em oncologia, Universidade Federal Fluminense, Rio de Janeiro, Brasil.
Boulanger, J., Boursiquot, J. N., Cournoyer Md, G., Lemieux, J., Almanric, || K, Msc, B., & Guay Bpharm Msc, # M P. (2014). MANAGEMENT OF HYPERSENSITIVITY TO CHEMOTHERAPY Management of hypersensitivity to platinum-and taxane-based chemotherapy: cepo review and clinical recommendations. Current OnCOlOgy, 21(4). https://doi.org/10.3747/co.21.1966
Brasil. (2018). Ministério da Saúde. ABC do câncer: abordagens básicas para o controle do câncer. Instituto Nacional de Câncer José Alencar Gomes da Silva. Rio de Janeiro, INCA:2018.https://www.inca.gov.br/sites/ufu.sti.inca.local/files//media/document//livro-abc-4-edicao.pdf
Cancer Institute, N. (2009). Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0. http://www.meddramsso.com
Castro, I. J., Pons Busom, M., Ballesteros Cabañas, G. I., Ramió Montero, E., Álvarez Méndez, A., de Castro Chivato, R., & Centelles Ruiz, M. (2013). Estudio de las reacciones adversas relacionadas con la infusión de paclitaxel y docetaxel. Farmacia Hospitalaria, 37(2), 88–94. https://doi.org/10.7399/FH.2013.37.2.374
Chen, F.-C., Wang, L.-H., Zheng, X.-Y., Zhang, X.-M., Zhang, J., & Li, L.-J. (2017). Meta-analysis of the effects of oral and intravenous dexamethasone premedication in the prevention of paclitaxel-induced allergic reactions. Oncotarget, 8(12), 19236–19243. www.impactjournals.com/oncotarget/
Conselho, F.de F. (2009). Farmácia hospitalar. Farmacêutico em oncologia: interfaces administrativas e técnicas. Instituto do Câncer do Ceará. https://pt.scribd.com/document/72131094/Farmaceutico-em-Oncologia-Interfaces-Administrativas-e-Clinicas
Gil, A. C. (2010). Como elaborar projetos de pesquisa (5 ed). Atlas.
Gobel, B. H. (2005). Chemotherapy-induced hypersensitivity reactions. Oncology Nursing Forum, 32(5), 1027–1035. https://doi.org/10.1188/05.ONF.1027-1035
Instituto, de C.T.Q. (2019) Farmacocinética clínica e farmacodinâmica. https://ictq.com.br/varejo-farmaceutico/838-farmacocinetica-clinica-e-farmacodinamica
Jerzak, K. J., Deghan Manshadi, S., Ng, P., Maganti, M., Mccuaig, J. M., Bulter, M., Oza, A., & Mackay, H. J. (2016). Prevention of carboplatin-induced hypersensitivity reactions in women with ovarian cancer. https://doi.org/10.1177/1078155216679028
Kintzel, P.E. (2001). Prophylaxis for Paclitaxel hypersensitivity reactions. Annals of Pharmacotherapy,35(9),1114-1117. Doi:10.13145/aph.10287
Lee, C., Gianos, M., & Klaustermeyer, W. B. (2009). Diagnosis and management of hypersensitivity reactions related to common cancer chemotherapy agents. In Annals of Allergy, Asthma and Immunology (Vol. 102, Issue 3, pp. 179–187). American College of Allergy, Asthma and Immunology. https://doi.org/10.1016/S1081-1206(10)60078-6
Lenz, H.-J. (2007). Management and Preparedness for Infusion and Hypersensitivity Reactions. https://doi.org/10.1634/theoncologist.12-5-601
Menezes, T. V. N., & Chinchila, I. (2011). Determinação de causalidade em processos de farmacovigilância. Trabalho de Pós-Graduação em Vigilância Sanitária, Pontífice Universidade Católica de Goiás, Goiás, Brasil 2011
Muallaoglu, S., Disel, U., Mertsoylu, H., Besen, A., Karadeniz, C., Sumbul, A.T., Abali, H., & Ozyilkan, O. (2013). Acute infusion reactions to chemotherapeutic drugs: A single institute experience. J Buon,18, 261–267.
Naranjo, C.A., Busto, U., Sellers, E.M., Sandor, P., Ruiz, I., Roberts, E.A., Janecek, E., Domecq, C., & Greenblett, D.J. (1981). A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther, 30(2):239-245.
Organização Mundial Da Saúde. (2005). Monitorização da segurança de medicamentos: diretrizes para criação e funcionamento de um centro de farmacovigilância. Brasília: Organização Pan-Americana da Saúde, 2005. https://bvsms.saude.gov.br/bvs/publicacoes/seguranca.pdf
Otto, S. (2002). Oncologia. Reichmann & Affonso Editores.
Pal, S., Dodoo, A., Mantel, A., & Olsson, S. (2011). THE WORLD MEDICINES SITUATION 2011 PHARMACOVIGILANCE AND SAFETY OF MEDICINES.
Polyzos, A., Tsavaris, N., Kosmasa, C., Arnaouti, T., Kalahanis, N., Tsigris, C., Giannopoulos, A., Karatzas, G., Giannikos, L., & Sfikakis, P. P. (2001) Hypersensitivity reactions to carboplatin administration are common but not always severe: A 10-year experience. Oncology, 61,129-133.
Randall, J. M., Bharne, A. A., & Bazhenova, L. A. (2013). Hypersensitivity reactions to carboplatin and cisplatin in non-small cell lung cancer. Journal of Thoracic Disease, 5(2). https://doi.org/10.3978/j.issn.2072-1439.2012.06.12
Ribeiro, T. dos S., & Santos, V. O. (2015). Segurança do Paciente na Administração de Quimioterapia Antineoplásica: uma Revisão Integrativa. Revista Brasileira de Cancerologia, 61(2), 145–153. https://doi.org/10.32635/2176-9745.RBC.2015V61N2.554
Shamim, S., Sharib, S. M., Malhi, S.M., Muntaha, S., Raza, H., Ata, S., Farooq, A. S., & Hussain, U. M. (2016). Adverse drug reactions (ADRS) reporting: awareness and reasons of under-reporting among health care professionals, a challenge for pharmacists. SpringerPlus, 5(1). https://doi.org/10.1186/S40064-016-3337-4
Shepherd, G. M. (2003). Hypersensitivity reactions to chemotherapeutic drugs. Clinical Reviews in Allergy & Immunology, 24(3), 253–262. https://doi.org/10.1385/CRIAI:24:3:253
Sidney, K. M. M., Romeu, G. A., & Pinheiro, C. (2017). Estudo de reações adversas ao paclitaxel em pacientes com câncer de mama em um hospital de referência. Revista Brasileira de Farmácia Hospitalar, 8 (1), 37-42.
Soares, L.C., Antonacci, M.H., Santana, M. da G & Schwartz, E. (2009). A quimioterapia e seus efeitos adversos: relato de clientes oncológicos. Cogityare Enferm, 14, 714-719.
Syrigou, E., Triantafyllou, O., Makrilia, N., Kaklamanos, I., Kotanidou, A., Manolopoulos, L., & Syrigos, K. (2010). Acute Hypersensitivity Reactions to Chemotherapy Agents: An Overview. Inflammation & Allergy-Drug Targets, 9, 206–213.
Weiss, R. B., Donehower, R. C., Wiernik, P. H., Ohnuma, T., Gralla, R. J., Trump, D. L., Jr, J. R. B., Echo, D. A. van, Hoff, D. D. von, & Leyland-Jones, B. (2016). Hypersensitivity reactions from taxol. Https://Doi.Org/10.1200/JCO.1990.8.7.1263, 8(7), 1263–1268. https://doi.org/10.1200/JCO.1990.8.7.1263
Wiernik, P. H., Schwartz, E. L., Strauman, J. J., Dutcher, J. P., Lipton, R. B., & Paietta, E. (1987). Phase I Clinical and Pharmacokinetic Study of Taxol1. CANCER RESEARCH, 47, 2486–2493.
World Health Organization. (2010). Uppsala monitoring centre. Programme for international drug monitoring. http://www.whoumc.org/DynPage.aspx?id=13140&mn= 1514#3.
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Copyright (c) 2021 Maihara da Silva Borges; Marcela Miranda Salles; Ranieri Carvalho Camuzi
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