*

Dr. Jorge Chirinos Rivera

Pediatra Neonatólogo
HNERM – Agosto 2017
¿RESPUESTA?
¿RESPUESTA?
* Farmacología
* Ciencia que estudia la composición, las propiedades y la
acción terapéutica de los medicamentos
* Farmacocinética
* La farmacocinética es la rama de la farmacología que
estudia los procesos a los que un fármaco es sometido a
través de su paso por el organismo
* Que hace el cuerpo al fármaco
* Farmacodinamia
* Rama de la farmacología que estudia la acción de los
medicamentos y sus efectos en el organismo vivo.
* Que hace el fármaco al cuerpo

*
GENÉRICOS VS “DE MARCA”
 NEONATOS
TASA DE FILTRACIÓN GLOMERULAR
SEGÚN LA EDAD GESTACIONAL Y
SEGÚN LA EDAD CRONOLÓGICA
TASA DE UTILIZACIÓN DE DROGAS EN NEONATOS
EN CANADÁ
ESCALA DE NARANJO PARA DEFINIR R.A.M.
R.A.M. MEDIADOS INMUNOLOGICAMENTE CON SUS MECANISMOS
“El futuro es un país aún por descubrir”
William Shakespeare
* Results Of the 3342 children exposed to
antidepressants during pregnancy, 4.1%
* Conclusions The association
(n=136) had a diagnosis of autism
compared with a 2.9% prevalence (n=353)
in 12 325 children not exposed to
antidepressants whose mothers had a
history of a psychiatric disorder (adjusted
odds ratio 1.45, 95% confidence interval
1.13 to 1.85). Propensity score analysis led
to similar results. The results of a sibling
control analysis were in the same
direction, although with wider confidence
intervals. In a negative control
comparison, there was no evidence of any
increased risk of autism in children whose
fathers were prescribed antidepressants
during the mothers’ pregnancy (1.13, 0.68
to 1.88). In all analyses, the risk increase
concerned only autism without
intellectual disability.
ANTIDEPRESIVOS EN EL EMBARAZO
between antidepressant use
during pregnancy and autism,
particularly autism without
intellectual disability, might not
solely be a byproduct of
confounding. Study of the
potential underlying biological
mechanisms could help the
understanding of modifiable
mechanisms in the aetiology of
autism. Importantly, the absolute
risk of autism was small, and,
hypothetically, if no pregnant
women took antidepressants, the
number of cases that could
potentially be prevented would
be small.
*
10.1136/bmj.j2811
* Both male and female rats exposed to plantar incision
injury at postnatal day 3 displayed mechanical
hypersensitivity that resolved by 24 hours post-
incision.
* When these animals reached adolescence (postnatal
day 28–40),neonatally-injured male rats showed
ipsilaterally-restricted mechanical, heat and cold
hypersensitivity, as well as social behavioral deficits.
* By contrast, these effects were not seen in females.
* Neonatal injury did not alter acute morphine
antinociception or the development of analgesic
tolerance in either sex.

* sex-
dependent
 Paracetamol: widely used and largely ineffective
No sirve para dolor de espalda agudo o crónico (a pesar guía NICE).
No sirve para osteoartritis (a pesar de guía NICE)
No sirve para dolor crónico neuropático
No sirve para dolor por cancer
Pobre respuestaen dolor por migraña o postoperatorio
Cochrane Mayor mortalidad por eventos adversos cardiovasculares
Aumenta al doble la tasa de transplante hepático
UK Para osteoartritis aumenta en 4 veces las pruebas hepáticas anormales
Trusted evidence. Hay estudios ahorita mismo para definir si es causa de autismo. Prevenir uso en gestantes y RN.
Informed decisions.
Better health. Hay estudios que podría ser causa de atopia e infertilidad.
PARACETAMOL
¿PREGUNTAS?