Determinação das concentrações plasmáticas e teciduais de itraconazol em pacientes com cromoblastomicose

Abstract

Chromoblastomycosis is a subcutaneous mycosis caused by deployment transcutaneous of several species of dematiaceous fungi, that is, melanized fungi. Considering the incidence of this disease in the state of Pará and the resulting morbidity of patients affected, with economic and social repercussions, it was made to the optimization of therapeutic schemes adopted, to the best knowledge of the relation dose x response. The itraconazole is one of the few drugs available for treatment, which has marked variability kinetic intra and inter individual, which compromises the establishment of the relation dose and response, as well as tissue and plasma concentrations achieved. In this sense, this work aimed at validation of analytical methodology by High Performance Liquid Chromatography and subsequent determination of itraconazole in samples of plasma and tissue in 20 patients with chromoblastomycosis, assisted in the laboratory of dermatoimmunology Dr. Marcello Candia, Marituba, Pará, who used the drug in doses of 200mg/day and 400mg/day. The technique employed was validated and proved adequate results in accordance with applicable law. Concentrations of plasma and tissue of itraconazole in the dose of 200mg/day were 121.3 87.9 ng/mL and 5.36 5.9 μg/g. The average plasma concentration of itraconazole in patients using 400mg/day was 290 234 ng/mL, and the plasma and tissue mean concentrations of itraconazole in patients who showed no clinical favourable, at doses of 200mg, making it necessary to increase to 400mg were 217 216 and 304 173 ng/mL; 14.87 12.94 e 21.80 6.62 μg/g. The average of relation between tissue and plasma concentrations in patients who had positive developments in clinical in the doses of 200mg/day was 44.29 67.12 and those that did not show positive developments in clinical in the doses of 200mg/day, making necessary to increase to 400mg/day were 68.52 59.90 and 71.71 38.26 respectively.