Fenômeno de Raynold primário e seu tratamento

Armanda Resende Ter Dez 17, 2013 12:58 pm

The Raynaud phenomenon (RP) is considered primary if the symptoms occur alone without any associated disorder; secondary RP refers to the presence of the disorder in association with a related illness, such as systemic lupus erythematosus or systemic sclerosis (scleroderma). Primary RP is sometimes also referred to as idiopathic RP or Raynaud disease.
An initially conservative, nonpharmacologic approach is therefore most important for these patients, although pharmacologic therapy may ultimately be necessary. By comparison, patients with secondary RP are more likely to have severe attacks, and disease management is more likely to be based upon pharmacologic agents while continuing
nonpharmacologic measures.
Clinical trials have demonstrated a 10 to 40 percent reduction in the frequency and severity of Raynaud attacks among placebo-treated patients with either primary or secondary Raynaud phenomenon (RP) . These findings suggest that a positive attitude, attention to the patient, and general education may be important factors in controlling attacks, and they emphasize the importance of placebo-controlled trials in evaluating the efficacy of a specific therapy.
An aggravating role of estrogen use is suggested by the finding that postmenopausal women using unopposed estrogens have a higher prevalence of RP [14]. However, the exact impact of estrogens is not fully defined.-->
We initiate pharmacotherapy in patients in whom general nonpharmacologic treatment measures alone are insufficient to adequately reduce the frequency and severity of attacks. We prefer to use one of the calcium channel blockers that have proven effective for primary and secondary Raynaud phenomenon (RP) as the initial choice for drug therapy