ABSTRACT
Las benzodiazepinas, tranquilizantes menores potentes, se recomiendan actualmente para el tratamiento de la ansiedad y en el área quirúrgica como inducción terapéutica del sueño fisiológico en el paciente que va a ser intervenido, a través de un mecanismo de acción facilitan la actividad inhibidora del neurotransmisor ácido gamma-amino butírico o GABA en el sistema nervioso central. A pesar que poseen un margen de seguridad y son drogas poco tóxicas, puede ocurrir que a través de los metabolitos demetilados de las benzodiazepinas, con una vida media mayor (la del diazepan alrededor de 33 horas, con una vida media inicial de 1,0) en dosis sucesivas su acumulación sea capaz de producir reacciones adversas, así como fenómenos de farmacodependencia. Su principal vía de excreción es la orina (70 a 90) y el resto en las heces a través de la bilis. La toxicidad se manifiesta con trastornos nerviosos, gastrointestinales, hematológicos y alérgicos que ceden con la supresión del medicamento. Presentamos a continuación un caso de intoxicación por benzodiazepina de una niña de 5 años de edad que ingresa con manifestaciones neurológicas importantes. Se discutirá el caso clínico, su sintomatología, tratamiento, así como una exhaustiva investigación en la bibliografía mundial.
Benzodiazepines, powerful minor tranquilizers, are currently recommended for anxiety treatment and in surgery as a therapeutic induction to physiological sleep in a patient who is going to OR. Through a mechanism of action facilitates the inhibitory activity of the gammaaminobutyric acid (GABA) neurotransmitter of the central nervous system. Although they have a safety margin and are not very toxic drugs it could happen that through their de-methylated metabolites with a longer half-life (diazepam half-life is about 33 hours, an a starting half-life of 1,0) in consecutive doses their accumulation could cause adverse reactions as well as dependence. Their main excretion way is urine (70 a 90 ) and the rest in feces or through the bile. Their toxicity shows nervous, gastrointestinal, hematologic, and allergic disorders that subside stopping medicine. Now we present a case of benzodiazepine poisoning of a 5 years old girl that was admitted with serious neurological signs. The symptoms and , treatment of the case will be discussed, as well as a thorough research in worldwide bibliography.
Subject(s)
Female , Child , Benzodiazepines/poisoning , Poisoning , Antidotes , Charcoal , DiazepamABSTRACT
The increase of pharmaceutical drugs formulations consumption by Brazilian population demanded a greater action from the official laboratory to verify the conformity of these products, as the majority of them are composed by anxiolytics. This study reports a serious manipulation error in preparing alprazolam capsules formulation, where the chlordiazepoxide was placed instead of alprazolam, being both drugs belonged to therapeutic class of the benzodiazepines. A warning on the importance of manipulation process control of drugs is presented.
O aumento do consumo de medicamentos manipulados pela população brasileira demandou uma maior ação por parte do laboratório oficial na avaliação da conformidade desses produtos que, em grande parte, são constituídos por fármacos com propriedades ansiolíticas. No presente trabalho, é relatado um grave erro de manipulação em cápsulas de alprazolam, o qual foi trocado pelo clordiazepóxido, ambos pertencentes à classe terapêutica das benzodiazepinas. Alerta-se para a importância do controle de qualidade do processo de manipulação de fármacos.