Publication: Hiperpotasemia inducida por medicamentos: problemática en la Comunidad de Madrid. Asesoramiento desde la oficina de farmacia
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2018-03-01
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Universidad Complutense de Madrid
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Abstract
Durante los últimos años, en España, la población de edad avanzada, con patologías crónicas y tratamientos farmacológicos, ha aumentado de forma importante, población que acude a las oficinas de farmacia, donde periódicamente el farmacéutico le dispensa, proporciona seguimiento y consejos de salud. La hiperpotasemia es una alteración que afecta a la población mayor, y en ocasiones está inducida por los medicamentos que utilizan; no es muy frecuente, pero podría ser muy grave; por ello la prevención podría ser fundamental para evitarla. Se produce cuando el K en sangre se eleva por encima de 5 mEq/L; que difícilmente ocurre en personas sanas con una función renal normal. Se clasifican en leves, moderadas y graves, produciendo, esta última, una mortalidad elevada. La hiperpotasemia leve es asintomática, suponiendo un riesgo oculto que podría desencadenar un episodio grave. Los factores de riesgo más comunes son la edad avanzada, problemas renales, enfermedades cardiovasculares (ECV) y diabetes, así como la influencia de medicamentos. Esta alteración se podría manejar mediante el control de fármacos inductores y de la ingesta de alimentos ricos en potasio. Entre los años 2011 y 2014, la Agencia Española de Medicamentos Productos Sanitarios, publicó 4 notas informativas dirigidas a sanitarios referidas al aumento de hiperpotasemia graves provocadas por medicamentos, demostrando su preocupación por el tema. Estas notas se referían a medicamentos solos o en combinaciones y fijaban precauciones de control de valores y restricciones en su uso, especialmente en pacientes con enfermedad renal y diabéticos. El objetivo general es conocer la problemática de la hiperpotasemia inducida por medicamentos en la Comunidad de Madrid y plantear un procedimiento de actuación desde la farmacia, para detectar y orientar a los pacientes de riesgo y contribuir a su prevención...
In recent years, in Spain, the elderly population, with chronic pathologies and drugs treatments, has increased significantly, a population that often goes to the pharmacy, where the pharmacist dispenses, provide follow-up and health advice. Hyperkalemia is a disturbance that affects to the elders, and is sometimes is drug induced; is not very common, but could be so dangerous. Prevention could be very important to avoid it. It occurs when the K in blood rises above 5 mEq / L, which infrecuently occurs in healthy normal renal function people. They are classified into mild, moderate and severe, this one produce a high mortality. Mild hyperkalemia is asymptomatic, assuming a hidden risk that could trigger a serious episode. The most common risk factors are advanced age, chronic kidney disease (CKD), cardiovascular disease (CVD) and diabetes, as well as the influence of medications. This problem could be managed by the control of drug inducers and the intake of foods rich in potassium. Between the years 2011 and 2014, the Spanish Agency of Medicines, published 4 informative advices addressed to sanitaries proffesionals referred to drugs caused severe hyperkalemia increases, showing their concern about the issue. These notes referred to drugs alone or in combinations and established safety recomendations and restrictions on their use, especially in patients with CKD and diabetics. The general objective is to understand the problem of drug-induced hyperkalemia in the Madrid region and to propose an action procedure from the pharmacy to detect and guide patients at risk and contribute to their prevention...
In recent years, in Spain, the elderly population, with chronic pathologies and drugs treatments, has increased significantly, a population that often goes to the pharmacy, where the pharmacist dispenses, provide follow-up and health advice. Hyperkalemia is a disturbance that affects to the elders, and is sometimes is drug induced; is not very common, but could be so dangerous. Prevention could be very important to avoid it. It occurs when the K in blood rises above 5 mEq / L, which infrecuently occurs in healthy normal renal function people. They are classified into mild, moderate and severe, this one produce a high mortality. Mild hyperkalemia is asymptomatic, assuming a hidden risk that could trigger a serious episode. The most common risk factors are advanced age, chronic kidney disease (CKD), cardiovascular disease (CVD) and diabetes, as well as the influence of medications. This problem could be managed by the control of drug inducers and the intake of foods rich in potassium. Between the years 2011 and 2014, the Spanish Agency of Medicines, published 4 informative advices addressed to sanitaries proffesionals referred to drugs caused severe hyperkalemia increases, showing their concern about the issue. These notes referred to drugs alone or in combinations and established safety recomendations and restrictions on their use, especially in patients with CKD and diabetics. The general objective is to understand the problem of drug-induced hyperkalemia in the Madrid region and to propose an action procedure from the pharmacy to detect and guide patients at risk and contribute to their prevention...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Farmacia, Departamento de Nutrición y Bromatología II (Bromatología), leída el 13-07-2017