Концентрације антихипертензивних лекова код давалаца крви

Abstract

UVOD: Učestalost kardiovaskularnih bolesti je visoka i predstavlja jedan od najčešćih uzročnika morbiditeta i mortaliteta. Među evropskim zemljama najviši mortalitet od kardiovaskularnih bolesti beleži se u Srbiji. Hipertenzivna bolest je hronično oboljenje i često zahteva dugotrajnu medikamentoznu terapiju antihipertenzivnim lekovima. Osobe koje boluju od arterijske hipertenzije, koja je stabilna i dobro kontrolisana antihipertenzivnim lekovima, a čija doza nije menjana poslednje četiri nedelje, mogu biti davaoci krvi. MATERIJAL I METODE: Istraživanje je sprovedeno tokom 2012. godine na teritoriji grada Novog Sada i JužnoBačkog okruga. Prikupljeno je 450 uzoraka krvi od dobrovoljnih davalaca, oba pola, starosti od 18 do 65 godina, koji boluju od hipertenzivne bolesti, a koji u cilju terapije koriste antihipertenzivne lekove. Prikupljeni uzorci plazme analizirani su metodom tečne hromatografije visokih performansi (HPLC). REZULTATI: Analizom je utvrđeno prisustvo antihipertenzivnih lekova, iznad limita kvantifikacije, u 47 uzoraka. Prisustvo metoprolola je utvrđeno u 35, a bisoprolola u 12 uzoraka. U preostalim uzorcima zabeleženo je prisustvo ispitivanih lekova u količinama koje su bile iznad limita detekcije, ali ispod limita kvantifikacije. Detektovane koncentracije metoprolola se nalaze u terapijskom rasponu i za očekivati je da bi kod primaoca bili merljivi znaci efekta leka. Kod niskih detektovanih koncentracija bisoprolola verovatnoća pojave terapijskog efekta je mala i ne može se isključiti, jer bisprolol pokazuje terapijske efekte u rasponu koncentracija od 0,01 do 0,06 mcg/mL. ZAKLJUČAK: Vremenski period privremenog prestanka uzimanja antihipertenzivnih lekova za većinu ispitivanih lekova je odgovarajući i iznosi 24 časa pre davanja krvi. Period privremenog prekidanja terapije od 24 časa pre davanja krvi za metoprolol i bisoprolol potrebno je korigovati u smislu njegovog produženja i implementacija u Vodiče za selekciju i odabir davalaca krvi.

INTRODUCTION: The incidence of cardiovascular diseases is high and is one of the most common causes of morbidity and mortality among European countries. The highest mortality from cardiovascular diseases is recorded in Serbia. A hypertensive disease is a chronic condition and often requires a long-term medicamentous therapy using antihypertensive medications. Persons suffering from arterial hypertension, which is stable and well controlled when using antihypertensive medications, can be blood donors, providing that the dosage has not been changed in the last four weeks of the treatment. MATERIAL AND METHODS: The study was conducted during 2012. in the city of Novi Sad area and the South Backa District. 450 blood samples were collected from volunteer donors of both sexes, aged 18. to 65., all suffering from a hypertensive disease, who used antihypertensive medications for the purpose of the therapy. The collected plasma samples were analyzed using the method of high performance liquid chromatography (HPLC). RESULTS: The analysis revealed the presence of antihypertensive drugs, that were above the limit of quantification, in 47 samples. The presence of metoprolol was determined in 35 samples, and bisoprolol was present in 12 samples. The remaining samples recorded the presence of the tested drugs in amounts that were above the detection limit, but below the limit of quantification. The detected concentrations of metoprolol are in the therapeutic range, and it is to be expected that a recipient would show measurable signs of drug effect. Regarding the low detected values of bisoprolol, the probability of a therapeutic effect is small and can not be excluded, since bisoprolol shows therapeutic effects in the concentration range of 0.01 to 0.06 mcg/mL. CONCLUSION: The period of time to temporary withdraw the dosage of antihypertensive drugs in most investigated medications proved to be appropriate and is 24 hours prior to blood donation. The period of time to temporary interrupt therapy of 24 hours before giving blood for metoprolol and bisoprolol analysis should be corrected in terms of its extension and implementation in the Blood donors selection guide.