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2018, Número 2

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Rev Med MD 2018; 9.10 (2)


Evolución de los fármacos antisecretores: Farmacología y usos clínicos

Lazcano-Becerra M, Velarde-Ruiz VJA, Aldana-Ledesma JM, Gómez-Castaños PC, Díaz-Aceves PE, García-Jiménez ES

Idioma: Español
Referencias bibliográficas: 61
Paginas: 174-184
Archivo PDF: 668.97 Kb.


RESUMEN

Los fármacos antisecretores han sido una necesidad médica histórica, contando con los primeros fármacos antisecretores (antimuscarínicos) en los 50s, sin embargo, fue en la década de los 70s, cuando se lanzó al mercado el primer antagonista del receptor de la histamina, la cimetidina, lo que marcó un parteaguas en el manejo de la enfermedad ácido péptica. Posteriormente surgió la ranitidina en los 80s, llegando a ser uno de los fármacos mejor vendidos en 1988.
Los inhibidores de bomba de protones han llegado a ser actualmente los fármacos más prescritos, incluso se pueden adquirir sin prescripción médica, lo que los ha puesto en los primeros lugares de medicamentos consumidos a nivel mundial. El omeprazol fue el primer inhibidor de la bomba de protones en el mercado en 1989, seguido del lansoprazol, rabeprazol, pantoprazol, esomeprazol y dexlansoprazol. Tal efectividad en la secreción ácida ha ocasionado efectos adversos asociados, como osteoporosis, alteraciones en la absorción de hierro, vitamina B12, hipomagnesemia, daño renal agudo y crónico, demencia, infarto agudo al miocardio, infección por Clostridium difficile, entre otros; a pesar de esto, la mayoría con poca evidencia y sólo reportado en estudios observacionales.
Estos medicamentos utilizarse en personas con indicación médica precisa y se debe de prescribir la menor dosis efectiva por el menor tiempo posible, para limitar la exposición indebida y limitar sus efectos adversos. Esta revisión se enfoca en los acontecimientos históricos, usos clínicos, efectos adversos y trascendencia del uso de los antisecretores, así como las proyecciones de su uso a futuro.


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