Aspectos farmacológicos y reacciones adversas a nivel gástrico y hepático de inhibidores de la bomba de protones
Palabras clave:
Inhibidores de la Bomba de Protones, reacciones adversas, antisecretores gástricos, omeprazol, bensimidazolesResumen
Introducción: Los inhibidores de bomba de protones (IBP) son los supresores de la secreción gástrica más eficaces, por lo que se encuentran entre los fármacos de primera elección en enfermedades que cursan con aumento de la secreción ácida gástrica. En los últimos años, diversos estudios básicos, clínicos y epidemiológicos han advertido sobre posibles eventos adversos potencialmente graves relacionados con la administración continuada y a largo plazo de este grupo de medicamentos.
Objetivo: Describir las principales reacciones adversas asociadas al consumo prolongado de inhibidores de la bomba de protones.
Métodos: Se efectúa revisión de la bibliografía disponible en CUMED, Scielo-Cuba y PubMed, entre los que se encuentran artículos de revisión, estudios básicos, clínicos, observacionales retrospectivos y prospectivos de cohorte, y metaanálisis.
Desarrollo: Se realiza una descripción de las principales características de los de IBP y se describen algunas de las reacciones adversas a largo plazo a nivel gástrico y en pacientes con cirrosis hepática.
Conclusiones: La asociación del uso de IBP con la aparición de efectos adversos puede conducir a una morbilidad y mortalidad no despreciables. Su prescripción inadecuada es un problema común y afecta a todos los niveles asistenciales. Las reacciones adversas de los IBP son las primarias (cefalea, diarrea, estreñimiento, náuseas y rash) y las secundarias (reducción del efecto antitrombótico del clopidogrel, riesgo de osteoporosis y fracturas, neumonía adquirida en la comunidad y neumonía nosocomial, infecciones por Clostridium difficile, eventos perinatales y posnatales, nefritis intersticial aguda, deficiencia de vitamina B12, hipomagnesemia, neoplasias y peritonitis bacteriana espontánea en pacientes con cirrosis).
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