Reacciones adversas inmunitarias y no inmunitarias a fármacos de uso perioperatorio

Olga Patricia Monge Ortega, Sandra Nora González, Alfredo Arias Cruz

Resumen


Las reacciones a medicamentos pueden ocurrir tanto por un mecanismo mediado por IgE como por un mecanismo no mediado por IgE. La alergia a fármacos es un tipo de reacción adversa a los medicamentos y comprende una gama de reacciones de hipersensibilidad mediadas por distintos mecanismos inmunológicos con diversas manifestaciones clínicas. Se estima una tasa de 3.2 casos fatales de anafilaxia asociada con las drogas por cada 100.000 habitantes por año y ésta parece ser aproximadamente 10 veces mayor en los pacientes hospitalizados. La incidencia de reacciones anafilácticas perioperatorias se estima que 1 de cada 10.000-20.000 procedimientos anestésicos. El diagnóstico se basa en una cuidadosa historia clínica y en el examen físico. En algunos casos, las pruebas cutáneas, los retos progresivos y los procedimientos de inducción de tolerancia a la droga pueden ser requeridos. En los pacientes hospitalizados y en el intervalo perioperatorio los relajantes musculares, los neurolépticos y los morfinomiméticos son frecuentemente utilizados y pueden ocurrir reacciones adversas a estos fármacos. Esta revisión muestra una información general sobre las reacciones de estos medicamentos, haciendo énfasis en las reacciones alérgicas, y aborda estrategias para el diagnóstico y manejo de estas reacciones. 


Palabras clave


Alergia; fármaco; perioperatorio; reacción adversa; inmunología.

Referencias


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DOI: http://dx.doi.org/10.29262/ram.v65i1.541

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