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1531 Drugs Administered in Sickle Cell Disease Vaso-Oclusive Crisis
  1. MZ Delago1,
  2. P Aliaga1,
  3. M Bandeira2,
  4. CA Teixeira3,
  5. FJ Ropero4,
  6. S Taniguchi5
  1. 1Albert Einstein Hospital
  2. 2Escola Paulista de Medicina
  3. 3Centro Universitário São Camilo
  4. 4UFABC
  5. 5Basic Sciences, Albert Einstein Hospital, São Paulo, Brazil

Abstract

Background and Aims The vascular occlusion of small vessels with blood cells in sickle cell disease leads to clinical manifestation such as pain crisis and organs’ chronic damage.

Objective To study the drugs administered for pain treatment in patients with sickle cell disease vaso-oclusive episodes.

Methods Our study included 40 patients with sickle cell disease with mean age 8.95+ 0.6 years old under pain treatment.

Results Clinical manifestations observed were vaso-oclusive crisis (100%), splenomegaly (17.5%), stroke (5%),icteric syndrome (5%), acute chest syndrome (2.5%), dyspnea (32.5%).

Patients with mild pain (10%) received dipyrone 22 mg/kg every 6 hours (100%) and tramadol 1.1 mg/kg q 4–8 h (75%).

Patients with moderate pain (52%) received dypirone 19 mg/kg q 6 hours (86%) and tramadol 1.1 mg/kg q 4–8 h (95%) and morphine 0.1 mg/kg every 3–6 hours (33%).

Patients with severe pain (37.5%) received dypirone 19 mg/kg q 6 hours (93%) and tramadol 1.2 mg/kg q 4–8 h (93%) and morphine 0.1 mg/kg every 3–6 hours (60%).

Patients who received tramadol i.v. in intervals over 6 hours (12.5%), and received morphine i.v.in intervals over 4 hours (10%) had moderate and intense pain.

Conclusions Tramadol and morphine i.v. should not be administered in intervals longer than 6 hours for tramadol and 4 hours for morphine due to its half life. (Tramadol T1/2:5.5.h and morphine T1/2: 2 hours).

Since dypirone inhibits cicloxigenase and reduces tromboxane levels in platelets, antiagregant effect should be evaluated in sickle cell disease patients.

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