Toxicidad hepática causada por medicamentos: revisión estucturada

Autores/as

  • Alejandra Cano Paniagua Universidad de Antioquia
  • Laura Milena Cifuentes Posada Grupo de Promoción y Prevención Farmacéutica
  • Pedro José Amariles Muñoz Universidad de Antioquia

DOI:

https://doi.org/10.22516/25007440.177

Palabras clave:

Enfermedad hepática, daño hepático inducido por medicamentos

Resumen

Objetivos: Elaborar un listado actualizado de medicamentos causantes de hepatotoxicidad e identificar, de acuerdo con la evidencia científica, los medicamentos con mayor probabilidad de causar hepatotoxicidad.

Método: Se realizó una búsqueda en PubMed/Medline utilizando términos Mesh: “Liver disease” y “Drug-induced Liver Injury”. La búsqueda se filtró por: reportes de casos, revisiones, ensayos clínicos, meta-análisis y cartas, hasta diciembre de 2015, en inglés, español y francés. Se incluyeron artículos con evidencia de hepatotoxicidad causada por medicamentos y referencias relevantes; fueron excluidos artículos sin relación con los objetivos de la búsqueda, relacionados con hepatotoxicidad por agentes diferentes, concernientes a otras causas de enfermedad hepática y/o relacionados con ensayos predictivos o células madre. Algunos aspectos de los medicamentos hepatotóxicos fueron: aparición de hepatotoxicidad, tipo de lesión, mecanismos de hepatotoxicidad, factores de riesgo y manifestaciones clínicas. Para valorar la probabilidad de aparición de hepatotoxicidad y del tipo de lesión se establecieron 3 categorías: Definida, probable y posible.

Resultados: Se identificaron 610 artículos de los cuales se eligieron 402, se excluyeron 208 artículos. Se elaboró un listado con 181 medicamentos y 17 formas farmacéuticas combinadas o regímenes terapéuticos con probabilidad de causar hepatotoxicidad, de estos, 6 medicamentos tuvieron probabilidad definida (metotrexato, minociclina, vancomicina, everolimus, isoniazida y tamoxifeno).

Conclusiones: Se identificaron más de 180 medicamentos hepatotóxicos, 6 tienen una probabilidad definida, mientras que para la mayoría es posible. La consolidación de la información demostró que diversas categorías de medicamentos tienen mayor probabilidad de ser causantes de toxicidad hepática.

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Lenguajes:

es

Biografía del autor/a

Alejandra Cano Paniagua, Universidad de Antioquia

Química farmacéutica y estudiante de Maestría

Laura Milena Cifuentes Posada, Grupo de Promoción y Prevención Farmacéutica

Química farmacéutica. Investigadora

Pedro José Amariles Muñoz, Universidad de Antioquia

Químico farmacéutico. Profesor vinculado de tiempo completo

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Publicado

2017-12-19

Cómo citar

Cano Paniagua, A., Cifuentes Posada, L. M., & Amariles Muñoz, P. J. (2017). Toxicidad hepática causada por medicamentos: revisión estucturada. Revista Colombiana De Gastroenterología, 32(4), 337–348. https://doi.org/10.22516/25007440.177

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