Palabras clave
Citocromo P450
Unidad de Cuidados Intensivos
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Resumen
Objetivo: Proporcionar información sobre las principales alteraciones fisiológicas que pueden influir en las propriedades farmacológicos en pacientes críticos e interacciones medicamentosas clínicamente relevantes mediadas por las enzimas del citocromo P450, con énfasis en los antifúngicos triazólicos. Revisión bibliográfica: Los pacientes hospitalizados en la Unidad de Cuidados Intensivos (UCI) suelen presentar alteraciones fisiológicas que provocan cambios en el perfil farmacológico de varios medicamentos. La presencia de disfunciones hepáticas y renales, hipoxia e isquemia periférica, trastornos circulatorios, elevación de marcadores inflamatorios, hipoalbuminemia y obesidad alteran los parámetros de absorción, distribución, metabolización y excreción de los fármacos. Estas modificaciones junto con el uso concomitante de varios fármacos representan un gran desafío para el abordaje farmacoterapéutico de estos pacientes. Entre las amplias clases farmacológicas, destacando los antifúngicos triazólicos por su repercusión y uso en UCI. Consideraciones finales: El conocimiento de los cambios farmacocinéticos en pacientes críticos y la modulación de las enzimas del citocromo P 450 es valioso para prevenir y manejar las posibles interacciones medicamentosas, especialmente en las UCI. La actuación conjunta de intensivistas y farmacéuticos clínicos puede plantearse optimizar el tratamiento farmacoterapéutico.
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