Determinação das concentrações plasmáticas de amitriptilina por cromatografia líquida de alta eficiência em pacientes com hanseníase e estados reacionais

Abstract

Leprosy is a granulomatous disease affecting the skin and peripheral nerves caused by Mycobacterium leprae. The alterations in peripheral nerves can originate pain symptoms and deformities, with consequent reduction of patient life quality. Amitriptyline is the drug of choice for the treatment of pain symptoms in patients with leprosy. Amitriptyline had a narrow therapeutic range and a great variability in plasmatic concentrations between patients. Thus the therapeutic monitoring of the plasmatic concentrations of this drug its a important tool for therapy optimization. In this sense this work aimed the validation of an analytical procedure for determination of amitriptyline by high performance liquid chromatography, in patients with hansenic reactions using amitriptyline daily doses of 25mg or 50mg, as well make the comparison between amitriptyline plasmatic concentrations in the presence or absence of multidrug therapy and in the reactions type I and II. This study was conducted in Tropical Medicine Institute from Para Federal University. Were enrolled 21 patients, 12(57%) male and 9 (43%) female. Eight patients (38%) were in curse of multidrug therapy and 10 (47%) presented hansenic reaction type I. The medium plasmatic amitriptyline concentration in dose of 25mg was 318144ng/mL and 361182ng/mL. No statistical significance was observed between medium plasmatic amitriptyline concentrations in doses of 25mg and 50mg, as well in the presence of multidrug therapy.