-RVH5DPRQ$JXLODU(3(6630DODJD

Guia de Farmacos
en Emergencias
Jose Ramon Aguilar
Reguero
EPES 061 S.P. Malaga
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  1. 1. -RVH5DPRQ$JXLODU(3(6630DODJD Guia de Farmacos en Emergencias Jose Ramon Aguilar Reguero EPES 061 S.P. Malaga
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  171. 171. -RVH5DPRQ$JXLODU(3(6630DODJD /$%(7$/2/ 7UDQGDWH
  172. 172. 35,1,3$/(6,1',$,21(6 +LSHUWHQVLyQDUWHULDOFULVLVKLSHUWHQVLYDV 35(6(17$,Ï135(3$5$,Ï1 8QDDPSROOD PO PJPO PJ
  173. 173. (QDPSPO*OR6)PO PJJW —JU
  174. 174. 3262/2*Ë$ $GXOWRV N %ROROHQWRGHPJGRVLVSRVWHULRUHVGHPJFDGD PLQXWRV N ,QIXVLyQFRPHQ]DUFRQPJPLQPOPLQ
  175. 175. 0i[LPRPJPLQ N 'RVLVPi[LPDWRWDOPJ 20(17$5,26 N %ORTXHDGRUDOIDVHOHFWLYR‰DGUHQpUJLFRQRVHOHFWLYR N (IHFWRPi[LPRGHXQERORDORVPLQXWRV N 'XUDFLyQGHOHIHFWRHQWUHKRUDV N /DKLSRWHQVLyQSRVWXUDOSXHGHGXUDUYDULDVKRUDV N 1RXVDUHQDVPDEURQTXLDOLQVXILFLHQFLDFDUGLDFDEORTXHR$9 GHžRžJUDGREUDGLFDUGLDVHYHUD N 6LH[LVWHEUDGLFDUGLDJUDYHDGPLQLVWUDUPJGHDWURSLQDLY N 1RPH]FODUFRQELFDUERQDWR
  176. 176. -RVH5DPRQ$JXLODU(3(6630DODJD /,'2$,1$ /LQFDtQD
  177. 177. 35,1,3$/(6,1',$,21(6 $UUtWPLDVYHQWULFXODUHV 35(6(17$,Ï135(3$5$,Ï1 8QDDPSROOD PODO PJPO PJ
  178. 178. 8QYLDO PODO JPO PJ
  179. 179. (QPODOPO6)R*OPO PJJW PJ
  180. 180. 3262/2*Ë$ $GXOWRV N 'RVLVGHDWDTXHPJNJHQERORPOGHOLGRFDLQDDO SDUDNJ
  181. 181. VHJXLGRGHPJNJDORVPLQXWRV1R VREUHSDVDUPJNJGHGRVLVLQLFLDOWRWDO N 0DQWHQLPLHQWRFRPHQ]DUGHVGHODGRVLVODSHUIXVLyQGH PJPLQJWPLQ
  182. 182. 1RVREUHSDVDUPJPLQ 1LxRV N 'RVLVGHDWDTXHPJNJHQERORLY N 0DQWHQLPLHQWR—JUNJPLQHQSHUIXVLyQ 20(17$5,26 N 3XHGHDGPLQLVWUDUVHSRUYtDHQGRWUDTXHDODODVPLVPDVGRVLV GLVXHOWRHQPOGH6) N $QWLDUUtWPLFRFODVH,E N 3XHGHSUHYRFDUYpUWLJRVFULVLVFRQYXOVLYDVGHVRULHQWDFLyQ EORTXHRVFDUGtDFRV N /DVREUHGRVLVSURGXFHGHSUHVLyQFDUGLRUUHVSLUDWRULD FRMQYXOVLRQHV$WUDYLHVDODSODFHQWD N /DGRVLVLQLFLDOODGHPDQWHQLPLHQWRGHEHQVHUUHGXFLGDVDOD PLWDGHQFDVRVGH,VKRFNPDRUHVGHDxRV N ,VRQLDFLGDFORUDQIHQLFROSURSDQROROQRUDGUHQDOLQDFLPHWLGLQD UHGXFHQVXPHWDEROLVPR N )HQREDUELWDOHLVRSURWHUHQRODXPHQWDQVXPHWDEROLVPR N 1RPH]FODUFRQDPSLFLOLQDFHID]ROLQDIHQLWRLQD
  183. 183. -RVH5DPRQ$JXLODU(3(6630DODJD 0$1,72/ 35,1,3$/(6,1',$,21(6 5HGXFFLyQGHODSUHVLyQLQWUDFUDQHDO3,
  184. 184. 35(6(17$,Ï135(3$5$,Ï1 N 0DQLWRODO6ROXFLyQGHPO JVROXFLyQGHPO JPO PJ
  185. 185. N 0DQLWRODO6ROXFLyQGHPO JVROXFLyQGH PO JPO PJ
  186. 186. JGHPDQLWRO P2VP
  187. 187. 3262/2*Ë$ (QODKLSHUWHQVLyQLQWUDFUDQHDOJNJLYPO GHPDQLWRODOSDUDNJ
  188. 188. HQPLQVHJXLGRGH JNJFDGDKRUDVPOGHPDQLWRODOSDUDNJ
  189. 189. 1RUHFRPHQGDEOHVXSHUDUJNJKRUDV 20(17$5,26 N 'LXUpWLFRRVPyWLFR N /RVHIHFWRVFOtQLFRVDSDUHFHQHQPLQXWRVGXUDQGHVGH PHQRVGHKRUDKDVWDYDULDVKRUDV N /DVGRVLVVRQPXYDULDEOHVHQJHQHUDOGHEHQDGHFXDUVHDORV YDORUHVGHOD3, N 3XHGHSURGXFLUDXPHQWRGHOD3,SRUDXPHQWRGHODYROHPLD GHOIOXMRVDQJXLQHRFHUHEUDOSRUHIHFWRUHERWHH[DFHUEDU KHPRUUDJLDVLQWUDFUDQHDOHVDFWLYDV N 'HEHYLJLODUVHODWROHUDQFLDFDUGtDFDDXVFXOWDFLyQSXOPRQDU
  190. 190. ODGLXUHVLV N /DRVPRODULGDGSODVPiWLFDQRGHEHVXSHUDUORVP2VO N 9LJLODUVRGLRSRWDVLRJOXFHPLD N ,QFRPSDWLEOHFRQVDQJUHWRWDOFORUXURSRWiVLFRFORULURVyGLFR VROXFLRQHVIXHUWHPHQWHiFLGDVRDOFDOLQDV N (QXVRSURORQJDGRGHEHQUHSRQHUVHODVSpUGLGDVFRQ5LQJHU /DFWDWR
  191. 191. -RVH5DPRQ$JXLODU(3(6630DODJD 025),1$ ORUXURPyUILFR3DOH[
  192. 192. 35,1,3$/(6,1',$,21(6 'RORUVHGDFLyQHGHPDDJXGRGHSXOPyQ 35(6(17$,Ï135(3$5$,Ï1 $ODPS PO PJ $ODPS PO PJ (QPJPO6)RDJXDHVWpULOPO PJ
  193. 193. 3262/2*Ë$ $GXOWRV N (GHPDDJXGRGHSXOPyQ,$0PJPO
  194. 194. 3XHGH UHSHWLUVHODGRVLVFDGDPLQKDVWDXQWRWDOGHPJ 1LxRV N —JUNJLY 20(17$5,26 N $QDOJHVLDFHQWUDO N 3XHGHSURGXFLUGHSUHVLyQUHVSLUDWRULDEUDGLFDHGLDKLSRWHQVLyQ YyPLWRVUHDFFLRQHVDOpUJLFDVUHWHQFLyQXULQDULD N (IHFWRYHQRGLODWDGRU N 1RPH]FODUFRQDPLQRILOLQDELFDUERQDWRIHQLWRtQDPHSHULGLQD IHQREDUELWDOWLRSHQWDORWURV N RQYLHQHWHQHUDPDQR1DOR[RQDPJLY
  195. 195. -RVH5DPRQ$JXLODU(3(6630DODJD 1$/2;21$ 1DOR[RQH$EHOOy
  196. 196. 35,1,3$/(6,1',$,21(6 $QWDJRQLVPRGHORVQDUFyWLFRV 35(6(17$,Ï135(3$5$,Ï1 8QDDPSROOD PO PJ PJPOO1DDOPO —JUJW —JU
  197. 197. 3262/2*Ë$ $GXOWRV N 6REUHGRVLVGHQDUFyWLFRVPJHQEROR3XHGHUHSHWLUVHFDGD PLQXWRVKDVWDGRVLV N 'HSUHVLyQSRVWRSHUDWRULDSRUQDUFyWLFRVPJHQ LQWHUYDORVGHPLQXWRV N ,QIXVLyQ—JUPLQJWPLQ
  198. 198. VHJ~QUHUVSXHVWD 1LxRV N $GPLQLVWUDUPJNJGRVLVKDVWDGRVLV 20(17$5,26 N 3XHGHSURGXFLUKLSHUWHQVLyQLUULWDELOLGDGQiXVHDVYyPLWRV N 9LGDPHGLDPLQXWRV N /DLQIXVLyQVHXVDSDUDSUHYHQLUODUHFXUUHQFLDGHODGHSUHVLyQ UHVSLUDWRULDSRUQDUFyWLFRV N 3XHGHSUHFLSLWDUXQVtQGURPHGHDEVWLQHQFLDDJXGRHQ KHURLQyPDQRV N 3XHGHDGPLQLVWUDUVHDODVPLVPDVGRVLVSRUYtDLPSDUD SUHYHQLUODUHFXUUHQFLDGHODGHSUHVLyQUHVSLUDWRULD
  199. 199. -RVH5DPRQ$JXLODU(3(6630DODJD 1,752*/,(5,1$ 6ROLQLWULQD
  200. 200. 35,1,3$/(6,1',$,21(6 DUGLRSDWtDLVTXpPLFD,FRQWUROSHULRSHUDWRULRGHODWHQVLyQ DUWHULDOKLSRWHQVLyQFRQWURODGDFULVLVKLSHUWHQVLYD 35(6(17$,Ï135(3$5$,Ï1 8QDDPSROOD PO PJPO PJ
  201. 201. (QPJPO*OR6)PO PJJW —JU
  202. 202. 3262/2*Ë$ $GXOWRV N RPHQ]DUFRQ—JUPLQ—JWPLQ
  203. 203. DXPHQWDQGR —JU—JW
  204. 204. FDGDPLQ N 'RVLVPi[LPD—JUPLQ 1LxRV N 1RHVWiLQGLFDGDVXDGPLQLVWUDFLyQHQQLxRV 20(17$5,26 N 'LODWDGRUYHQRVRFRQDOJ~QHIHFWRDUWHULDO N 8VDUEDMRPRQLWRUL]DFLyQ N 9LGDPHGLDGHDPLQXWRV N 86$55(,3,(17(6'(9,'5,2$7e7(5(612 $%625%(17(6 N 1RHVWDEOHDWHPSHUDWXUDDPELHQWHFDPELDUODFDGDKRUDV
  205. 205. N RQWUDLQGLFDGRHQKHPRUUDJLDFHUHEUDO7(HLQFUHPHQWRGHOD SUHVLyQLQWUDFUDQHDO N 3XHGHSURGXFLUKLSRWHQVLyQVKRFNWDTXLFiUGLDUHIOHMD EUDGLFiUGLDSDUDGyMLFDFHIDOHD N 6LDSDUHFHKLSRWHQVLyQVXVSHQGHUHOIiUPDFRH[SDQGLU YROXPHQ N 6LKDKLSRWHQVLyQFRQEUDGLFDUGLDXVDUDWURSLQDPJLY N 1RPH]FODUFRQRWURVIiUPDFRV
  206. 206. -RVH5DPRQ$JXLODU(3(6630DODJD 1,7523586,$72 1LWURSUXVVLDW)LGHV
  207. 207. 35,1,3$/(6,1',$,21(6 DUGLRSDWtDLVTXpPLFD,FRQWUROSHULRSHUDWRULRGHODWHQVLyQ DUWHULDOKLSRWHQVLyQFRQWURODGDFULVLVKLSHUWHQVLYD 35(6(17$,Ï135(3$5$,Ï1 8QDDPSROOD PO PJPO PJ
  208. 208. (QPJPO*OR6)PO PJJW —JU
  209. 209. 3262/2*Ë$ $GXOWRV N RPHQ]DUFRQ—JUPLQ—JUPLQ
  210. 210. DXPHQWDQGR—JU —JW
  211. 211. FDGDPLQXWRV N 'RVLVPi[LPD—JUNJPLQ 1LxRV N $GPLQLVWUDU—JUNJPLQ 20(17$5,26 N 'LODWDGRUDUWHULDOYHQRVR N 3URWHJHUGHODOX]WRGRHOVLVWHPDGHLQIXVLyQXVDUORHQXQ Pi[LPRGHKRUDV N 86$5%$-2021,725,=$,Ï1 N 9LGDPHGLDGHDPLQXWRV N 3XHGHDXPHQWDUHODFODUDPLHQWRGHGLJR[LQD N 3XHGHSURYRFDULQWR[LFDFLyQSRUFLDQXURORVQLYHOHVGH WLRFLDQDWRQRGHEHQVREUHSDVDUPJGO
  212. 212. N (QFDVRGHKLSRWHQVLyQUHVLVWHQWHDODH[SDQVLyQGHYROXPHQ DGPLQLVWUDUIHQLOHIULQD—JUPLQLY N 1RPH]FODUFRQRWURVIiUPDFRV
  213. 213. -RVH5DPRQ$JXLODU(3(6630DODJD 352$,1$0,'$ %LRFRUO
  214. 214. 35,1,3$/(6,1',$,21(6 7UDVWRUQRVGHOULWPRDXULFXODUHVYHQWULFXODUHV 35(6(17$,Ï135(3$5$,Ï1 8QDDPSROOD PO JPO PJ
  215. 215. (QDPSPOGH*OPO PJJW PJ
  216. 216. 3262/2*Ë$ $GXOWR N 'RVLVLQLFLDOPJPO
  217. 217. HQPLQXWRUHSLWLHQGRFDGD PLQXWRVKDVWDVXSUHVLyQGHODDUUtWPLDRDSDULFLyQGHWR[LFLGDG RGRVLVWRWDOGHJUDPR N 0DQWHQLPLHQWRPJPLQJWPLQ
  218. 218. 1LxRV N 'RVLVLQLFLDOPJNJ N 0DQWHQLPLHQWR—JUNJPLQ 20(17$5,26 N $QWLDUUtWPLFRWLSR,D N /DWR[LFLGDGVHPDQLILHVWDSRUHQVDQFKDPLHQWRGHO456 SURORQJDFLyQGHO35HO47HKLSRWHQVLyQ N 6LHQGRVLVLQLFLDOHO35VHSURORQJD456VHHQVDQFKDPiVGH ROD7$GLVPLQXHPiVGHPPKJSDUDUODDGPLQLVWUDFLyQ N RQWUDLQGLFDGRHQEORTXHR$9FRPSOHWRWRUVDGHGHSRLQWHV PLDVWHQLDJUDYLV/(6 N 0RQLWRUL]DU(*7$ N 1RPH]FODUFRQIHQLWRtQDDPLQRILOLQDELFDUERQDWR
  219. 219. -RVH5DPRQ$JXLODU(3(6630DODJD 35235$12/2/ 6XPLDO
  220. 220. 35,1,3$/(6,1',$,21(6 7UDVWRUQRVGHOULWPRDXULFXODUHVYHQWULFXODUHVLVTXHPLD PLRFiUGLFD+7$PLRFDUGLRSDWtDREVWUXFWLYDFULVLVKLSHUWLURLGHD 35(6(17$,Ï135(3$5$,Ï1 8QDDPSROOD PO PJPO PJ
  221. 221. 3262/2*Ë$ $GXOWRV N $GPLQLVWUDUPJHQXQPLQXWRUHSHWLGRFDGDPLQXWRV 'RVLVPi[LPDPJ 1LxRV N $GPLQLVWUDUPJNJHQPLQXWRV 20(17$5,26 N 6XXVRLYHVH[FHSFLRQDOYtDRUDOSUHIHUHQWH
  222. 222. N %ORTXHDGRUEHWDQRVHOHFWLYRFRQHIHFWRVDQWLDUUtWPLFRVH KLSRWHQVRU$QWLDUUtWPLFRWLSR,, N 'LVPLQXHODFRQWUDFWLOLGDGDODUJDODFRQGXFFLyQ$9 N RQWUDLQGLFDGRHQEORTXHR$9GHDOWRJUDGR,%12 ULQLWLVDOpUJLFD N 8VDUFRQSUHFDXFLyQHQGLDEHWHV, N RPLHQ]DVXDFFLyQDORVPLQXWRVGXUDGHDKRUDV N 'HEHXVDUVHEDMRPRQLWRUL]DFLyQ N (YtWHVHODVXSUHVLyQEUXVFDGHOIiUPDFR
  223. 223. -RVH5DPRQ$JXLODU(3(6630DODJD 6$/%87$02/ 9HQWROtQ
  224. 224. 35,1,3$/(6,1',$,21(6 %URQFRHVSDVPR 35(6(17$,Ï135(3$5$,Ï1 8QDDPSROOD PO —JU (QDPSPO6)R*OPO —JUJW —JU
  225. 225. 3262/2*Ë$ $GXOWRV N 'RVLVLQLFLDO—JUSUHIHUHQWHPHQWHVFRLP UHSLWLHQGRFDGDKRUDVVLIXHUDQHFHVDULR 3XHGHDGPLQLVWUDUVHLYDUD]yQGH—JUNJHQWUHòôGH DPSROODSDUDNJ
  226. 226. HQPOGH6)DSDVDUHQPLQXWRV POPLQ
  227. 227. N (QSHUIXVLyQVLVHFRQVLGHUDQHFHVDULR
  228. 228. FRPHQ]DUFRQ —JUPLQ—JWPLQ
  229. 229. KDVWD—JUPLQ—JWPLQ
  230. 230. GH GLOXFLyQ 20(17$5,26 N (VWLPXODQWH‰DGUHQpUJLFR N (VSUHIHULEOHVXXWLOL]DFLyQHQLQKDODGRU N (QDGPLQLVWUDFLyQLYGHEHPRQLWRUL]DUVHDOSDFLHQWH N /DVGRVLVYDULDQVHJ~QODUHVSXHVWDGHOSDFLHQWH N 3XHGHSURYRFDUDUUtWPLDVJUDYHVDXPHQWRGHOFRQVXPR PLRFiUGLFRGHR[tJHQR N 3XHGHDXPHQWDUORVQLYHOHVGHJOXFHPLD N 1RGHEHPH]FODUVHFRQEORTXHDGRUHVEHWD N 1RDGPLQLVWUDUHQSULPHUVHJXQGRWULPHVWUHGHOHPEDUD]R N 1RPH]FODUHQODPLVPDMHULQJDFRQRWURVIiUPDFRV
  231. 231. -RVH5DPRQ$JXLODU(3(6630DODJD 68/)$72'(3527$0,1$ 35,1,3$/(6,1',$,21(6 1HXWUDOL]DUHOHIHFWRGHODKHSDULQD 35(6(17$,Ï135(3$5$,Ï1 8QDDPSROOD PO PJPO PJ
  232. 232. 3262/2*Ë$ N 8QPLOLJUDPRQHXWUDOL]D8,PJ
  233. 233. GHKHSDULQD N 6HDGPLQLVWUDHQIRUPDLYOHQWD N 1RH[FHGHUPJHQXQSHULRGRGHPLQXWRV N 6HSXHGHUHSHWLUODGRVLVDORVPLQXWRVVLHVQHFHVDULR 20(17$5,26 N 3XHGHSURGXFLUGHSUHVLyQPLRFiUGLFDYDVRGLODWDFLyQSHULIpULFD FRQKLSRWHQVLyQEUDGLFDUGLDEUXWDOHV N 3XHGHWHQHUHIHFWRDQWLFRDJXODQWHVLQRVH[FHGHPRVHQODGRVLV N /DQHXWUDOL]DFLyQWUDQVLWRULDGHODKHSDULQDSXHGHVHUVHJXLGDGH XQHIHFWRUHERWH N 1RPH]FODUORFRQFHIDORVSRULQDVRSHQLFLOLQD N /DKLSRWHQVLyQSXHGHUHTXHULUGRSDPLQDODEUDGLFDUGLD DWURSLQD
  234. 234. -RVH5DPRQ$JXLODU(3(6630DODJD 9$6235(6,1$ 35,1,3$/(6,1',$,21(6 +HPRUUDJLDSRUYDULFHVHVRIiJLFDV 35(6(17$,Ï135(3$5$,Ï1 8QDDPSROOD PO 8, (Q8,PO*OR6)PO 8,JW 8,
  235. 235. 3262/2*Ë$ $GXOWRV N $GPLQLVWUDU8,PLQ—JWPLQ
  236. 236. GXUDQWHKRUDVVHJXLGR GH8,PLQ—JWPLQ
  237. 237. KRUDVPiV N 2ELHQ8,PLQGXUDQWHPLQXWRVDXPHQWDQGRVLQR FHVD8,PLQPiVFDGDPLQXWRVKDVWDXQPi[LPRGH 8,PLQ—JWPLQ
  238. 238. 3HULRGRGHSUXHEDGHDKRUDV 20(17$5,26 N (Q,$0DQJRUSXHGHXWLOL]DUVHFRQFRPLWDQWHPHQWHFRQ QLWURJOLFHULQDHQSDUFKHXRWUDYtDSDUDFRQWUDUUHVWDUORVHIHFWRV YDVRSUHVRUHVFRURQDULRV N 6XHIHFWRFRPLHQ]DDORVPLQXWRV N 3XHGHSURGXFLULQWR[LFDFLyQSRUDJXDFRQWUDFWXUDGHOD PXVFXODWXUDOLVD N 6HUHFRPLHQGDUHWLUDUJUDGXDOPHQWH N 1RPH]FODUFRQKHSDULQDEORTXHDGRUHVJDQJOLRQDUHVRWURV
  239. 239. -RVH5DPRQ$JXLODU(3(6630DODJD 9(5$3$0,/ 0DQLGyQ
  240. 240. 35,1,3$/(6,1',$,21(6 7693IO~WHU$)$ 35(6(17$,Ï135(3$5$,Ï1 8QDDPSROOD PO PJ (QDPSPJ
  241. 241. PO*OR6)PO PJ JW PJ
  242. 242. 3262/2*Ë$ N 6HDGPLQLVWUDHQERORLYOHQWRPLQ
  243. 243. N 0RQLWRUL]DUDOSDFLHQWH $GXOWRV N PJLQLFLDOPHQWHPJNJ
  244. 244. 5HSHWLUPJDORV PLQXWRVVLQRVHREWLHQHHOHIHFWRGHVHDGR N 3HUIXVLyQVLHVWXYLHUDLQGLFDGD
  245. 245. PJKRUDJWPLQ GHODVROXFLyQ
  246. 246. VLQSDVDUGHPJGtD 1LxRV N 'HDDxR¶¶PJNJ0i[LPRPJ N 'HDDxRV¶¶PJNJVLQSDVDUGHPJ0i[LPDGRVLV WRWDOPJ 20(17$5,26 N (VXQEORTXHDGRUGHORVFDQDOHVOHQWRVGHOFDOFLR N $QWLDUUtWPLFRWLSR,9 N $ODUJDLQWHUYDOR35FRQHIHFWRFURQRWUySLFRHLQRWUySLFR QHJDWLYR N 9DVRGLODWDFLyQVLVWpPLFDFRURQDULD N RQWULQGLFDGRHQEORTXHR$9EUDGLFDUGLDVHYHUD,IDVH DJXGDGHO,$0HKLSRWHQVLyQJUDYH N 3XHGHDFHOHUDUXQD)$RXQD7693FRQ456DQFKR N 1RDVRFLDUORFRQEORTXHDGRUHVEHWD N 1RPH]FODUORFRQDOE~PLQDELFDUERQDWRHKLGUDODFLQD
  247. 247. -RVH5DPRQ$JXLODU(3(6630DODJD ,1)86,Ï1,175$9(26$ 'XUDFLyQHQIXQFLyQGHOYROXPHQ /Ë48,'2$3(5)81',5
  248. 248. +25$6 *27$63250,1872 ò

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