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Inicio Gaceta Médica de Bilbao Antiinflamatorios no esteroideos y paracetamol en el tratamiento del dolor
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Vol. 104. Núm. 4.
Páginas 148-155 (enero 2007)
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Vol. 104. Núm. 4.
Páginas 148-155 (enero 2007)
Acceso a texto completo
Antiinflamatorios no esteroideos y paracetamol en el tratamiento del dolor
Nonsteroidal anti-inflamatory drugs and paracetamol in pain treatment
Antiinflamatorio ez- esteroideoak eta parazetamola minaren tratamenduan
Visitas
140875
Vicente Ortiz-Pereda1,
Autor para correspondencia
vortip@gmail.com

Correspondencia: Vicente Ortiz-Pereda. Servicio de Anestesia, Reanimación y tratamiento del Dolor. Hospital de Basurto. 48013 Bilbao. Bizkaia. España UE.
, Maite López1, Agustín Arroita1, Luciano Aguilera2, Jon Azkue3, F. Torre-Mollinedo4, A. Isla-Baranda5
1 Unidad del Dolor del Hospital de Basurto. Servicio de Anestesiología, Reanimación y Tratamiento del Dolor. Bilbao. Bizkaia. España. UE
2 Servicio de Anestesiología, Reanimación y Tratamiento del Dolor del Hospital de Basurto. Bilbao. Bizkaia. España. UE
3 Profesor adjunto al Departamento de Neurociencias, Escuela de Medicina y Odontología, Universidad del País Vasco. Leioa. Bizkaia. España. UE
4 Unidad del Dolor del Hospital de San Eloy. Servicio de Anestesiología, Reanimación y Tratamiento del Dolor. Barakaldo. Bizkaia. España. UE
5 Unidad del Dolor del Hospital de Galdakao-Usansolo. Servicio de Anestesiología, Reanimación y Tratamiento del Dolor. Galdakao. Bizkaia. España. UE
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Resumen

Los antiinflamatorios no esteroideos (AINES) y el PARACETAMOL incluye un grupo de fármacos con estructuras químicas diferentes que forman junto a la medicación coadyuvante el primer escalón del tratamiento del dolor propuesto por la OMS o que complementa la analgesia en los demás escalones. Estos medicamentos poseen un mecanismo de acción periférico sobre el proceso inflamatorio y también central minorando la transmisión del impulso doloroso. Se estudia su eficacia en los diversos tipos de dolor. Se discutirá la posibilidad de obtener analgesia con estos fármacos valorando las distintas familias de los mismos y sus características farmacológicas específicas, incluyendo los nuevos inhibidores selectivos de la COX-2. Se revisan los efectos adversos de estos medicamentos en especial sus acciones en el sistema gastrointestinal, renal, cardiovascular, hepático y hematológico, sus reacciones de hipersensibilidad y posibles interferencias medicamentosas. Por ultimo se sugiere una guía para su uso correcto.

Palabras clave:
Antiinflamatorios no esteroideos
paracetamol
dolor agudo
dolor crónico
dolor oncológico
analgesia
efectos adversos
Summary

Nonsteroidal anti-inflammatory drugs (NSAIDS) and PARACETAMOL include a group of medications with different chemical structures which form, together with coadyuvant medication, the first step in pain treatment proposed by the OMS or which complements analgesia in other steps. These medications have a peripheral mechanism which acts on the inflammation and a central one which decreases pain transmission. A discussion will take place over the possibility of obtaining analgesia with these drugs valuing their different families and their pharmacological characteristics, including new selective COX-2 inhibitors. These medications' adverse effects are revised, especially their actions in the gastrointestinal, renal, cardiovascular, hepatic, and hematological systems, their hypersensibility reactions and possible medicinal interferences. Finally, a guideline of correct use is suggested.

Key words:
nonsteroidal anti-inflamatory drugs
paracetamol
acute pain
chronic pain
cancer pain
analgesia
adverse effects
Laburpena

Antiinflamatorio ez esteroideoek (AIEE) eta parazetamolak egitura kimiko ezberdineko farmako talde bat osatzen dute. MOEk proposatutako minaren tratamendu-eskeileraren lehenengo maila osaten dute, sendagai osagarriekin batera, eta eskailararen gainontzeko mailetan ere analgesia osatxeko erabiltzen dira. Sendagaion eragina periferian gauzatzen da, inflamazioan bertan, baina eragina dute baita erdiko nerbio sisteman ere, minaren garraio sinaptikoa eragotziz. Lan honetan min mota ezberdinetan duen eragina aztertzen da. Analgesia lostzeko duten ahalmena izango da hizpide, familia ezberdinen farmakologi ezaugarri bereziak aintzat hartuz, eta COX-2ren berariazko eragozleak ere aztertuz. Sandagai hauen albo eraginak aztertzen dira, batez ere digestio-aparatuan, gernu aparatuan, bihotz eta hodi aparatuan, gibelean eta odolean dituen eraginak, eta baita sortzen dituzten hipersentsibilitate erreakzioak eta beste farmakoekiko elkarreraginak ere. Azkenik, sendagaiok egoki erabiltzeko jarraibideak proposatzen dira.

Hitz gakoak:
Antiinflamatorio ez- esteroideoak
Parazetamola
Min akutua
Min kronikoa
Min tumorala
Analgesia
Eragin desiragaitzak
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