La importante capacidad inhibitoria de la secrecion acida gastrica de los inhibidores de la bomba de protones (IBP) los convierte en los farmacos de eleccion en las enfermedades relacionadas con el acido. La elevada prevalencia de esas enfermedades y la necesidad de mantener la administracion del farmaco durante periodos muy prolongados determinan que este grupo terapeutico sea uno de los de mayor volumen de gasto para el sistema sanitario. Sin embargo, con la enorme generalizacion de su uso, aun siguen aflorando periodicamente reservas sobre su potencial toxicidad, una opinion basada en una cierta desconfianza sobre la especificidad de su mecanismo de accion y en la sensacion consiguiente de que algo tan potente debe conllevar una contrapartida lesiva. Los IBP actuan selectivamente en el eslabon final del proceso de secrecion del acido gastrico, la H+/K+-ATPasa o bomba de protones. Esta enzima representa un paso obligado en el proceso de secrecion de H+, y los IBP son muy especificos de la celula parietal, porque para actuar necesitan de un ambiente con unos valores de pH muy bajos, que solo se dan en el canaliculo secretor de esa celula. En el presente articulo se revisa los efectos adversos de los IBP, hacienda especial enfasis en los relacionados con su administracion continuada y en ciertas circunstancias relacionadas con situaciones especiales de los pacientes, como la ancianidad, la insuficiencia hepatica, la gestacion y la lactancia materna y la infancia. Todos los IBP comercializados comparten una base quimica comun y no hay grandes diferencias en sus potenciales efectos adversos, la posibilidad de favorecer infecciones oportunistas o su capacidad de generar interacciones farmacocineticas con otros farmacos que, en general y cuando se las refiere, son de poca entidad. Tras 2 decadas de uso, se confirma que los IBP son farmacos muy eficaces y seguros.

Seguridad de la utilización de los inhibidores de la bomba de protones

Aim To investigate the frequency and characteristics of adverse drug reactions (ADRs) in hospitalised neonates to obtain a better understanding of and improvement in neonatal healthcare. Methodology A prospective cohort study. Data were collected on 313 neonates and 2166 drug prescriptions. Clinical characteristics of patients, drugs administered and ADRs were prospectively recorded and analysed. Informed consent was obtained in all cases. Results 116 different ADRs were detected. 17% of the neonates experienced at least one of these ADRs. Systemic antimicrobials and caffeine citrate were the drugs that most commonly caused ADRs. According to the ADR Severity Assessment Scale, 41% were mild, 42% were moderate and 17% were severe. Of the ADRs identified, 11% were classified as ‘certain’ by the Naranjo method and 20% were classified as ‘defined’ by the Karch and Lasagna modified algorithm. Most of the ADRs detected were related to feed intolerance, phlebitis and tachycardia. Most were acute (73%) and lasted between 1 and 7 days (39%). After the occurrence of an ADR, it was necessary to initiate specific treatment in 44 cases, discontinue the drugs involved in 30 cases, and reduce the drug dose in another 30 cases. An association was shown between the number of drugs prescribed and ADR onset. Conclusions There is a high incidence of ADRs in hospitalised newborns, which increases with the number of prescriptions.

https://adc.bmj.com/content/archdischild/101/4/371.full.pdf

Adverse drug reactions in neonates: a prospective study

Purpose: The aim of this study was to develop a simple, rapid and sensitive reverse phase high performance liquid chromatography (RP-HPLC) method for quantification of sirolimus (SRL) in pharmaceutical dosage forms. Methods: The chromatographic system employs isocratic elution using a Knauer- C18, 5 mm, 4.6 × 150 mm. Mobile phase consisting of acetonitril and ammonium acetate buffer set at flow rate 1.5 ml/min. The analyte was detected and quantified at 278nm using ultraviolet detector. The method was validated as per ICH guidelines. Results: The standard curve was found to have a linear relationship (r2 > 0.99) over the analytical range of 125–2000ng/ml. For all quality control (QC) standards in intraday and interday assay, accuracy and precision range were -0.96 to 6.30 and 0.86 to 13.74 respectively, demonstrating the precision and accuracy over the analytical range. Samples were stable during preparation and analysis procedure. Conclusion: Therefore the rapid and sensitive developed method can be used for the routine analysis of sirolimus such as dissolution and stability assays of pre- and post-marketed dosage forms.

/pdf/development-and-validation-of-an-hplc-method-for-the-19e5zj95do.pdf

Development and Validation of an HPLC Method for the Analysis of Sirolimus in Drug Products

The equine gastric ulcer syndrome (EGUS) involves a complex of diseases associated with ulceration of the esophageal, stomach and duodenum mucosa of horses. EGUS occurs frequently due to multiple and overlapping risk factors (activity, food management, anti-inflammatory therapies, among others) and anatomo-physiological peculiarities of horses. The combination of therapeutic strategies and management and environmental shifts are important in both the preventive and the curative approach to this syndrome. However, further studies on the epidemiological and clinical aspects of EGUS and low-cost therapeutic alternatives are required.

/pdf/equine-gastric-ulcer-syndrome-risk-factors-and-therapeutic-4b9m796f49.pdf

Equine gastric ulcer syndrome: risk factors and therapeutic aspects

Pediatric patients present changing physiological features. Because of the lack of land suitable for commercial management, pediatric specialties very often need to prepare extemporaneous formulati...

Physicochemical and microbiological stability of two news oral liquid formulations of clonidine hydrochloride for pediatric patients.

Utilización de medicamentos en Unidades de Neonatología de 6 hospitales españoles

http://revistafarmaciahospitalaria.sefh.es/gdcr/index.php/fh/article/download/1025/1025

Comparación de la cromatografía líquida de alta resolución frente al enzimoinmunoensayo de micropartículas para la determinación de sirolimus en trasplante renal

Inhibidores de la bomba de protones en pediatría

Stability of pantoprazole in parenteral nutrition units

https://revistafarmaciahospitalaria.sefh.es/gdcr/index.php/fh/article/download/796/796

E. Valverde Molina

Papers

Utilización de medicamentos en Unidades de Neonatología de 6 hospitales españoles

Comparación de la cromatografía líquida de alta resolución frente al enzimoinmunoensayo de micropartículas para la determinación de sirolimus en trasplante renal

Inhibidores de la bomba de protones en pediatría

Stability of pantoprazole in parenteral nutrition units

Estabilidad de pantoprazol en unidades para nutrición parenteral