Síndromes de hipersensibilidad inducidos por medicamentos en las unidades de cuidados intensivos

Volumen 26, Número 3, julio-septiembre 2018

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Artículo de revisión

Rev Asoc Colomb Dermatol. 2018; 26 : 3 (julio - septiembre), 170-183

Síndromes de hipersensibilidad inducidos por medicamentos en las unidades de cuidados intensivos

Drug-induced hipersensitivity syndromes in intensive care units

Autor(es):

Díaz-Guío Diego Andrés

andres.diaz@vitalcare.co

Médico intensivista, Ph.D. (c) en Educación, Clínica Central del Quindío, CEO Vital Care, Centro de Simulación, Armenia, Colombia

Cardona Marcela

Médica general, Vital Care, Centro de Simulación Clínica, grupo EdSimC, Armenia, Colombia

Galindo Luisa Fernanda

Médica dermatóloga, Dermobog, Bogotá, D.C., Colombia

Resumen:

Las enfermedades cutáneas desencadenadas por medicamentos son comunes y, en su mayoría, no fatales; sin embargo, algunas de ellas menos frecuentes, son potencialmente mortales. Se destaca el espectro del síndrome de Stevens-Johnson/ necrólisis epidérmica tóxica y el síndrome de hipersensibilidad a medicamentos con eosinofilia y síntomas sistémicos.

Al ser enfermedades de baja incidencia, es común que el personal de cuidados intensivos no esté familiarizado con su presentación, diagnóstico y tratamiento, lo que puede asociarse con demoras en la atención adecuada y con impacto en la morbimortalidad.

En esta revisión narrativa se abordan estas entidades clínicas y se describe su asociación con medicamentos de uso frecuente en las unidades de cuidados intensivos; además, se tratan la fisiopatología, la presentación clínica y el tratamiento.

Palabras clave:

síndrome de Stevens-Johnson, síndrome de hipersensibilidad a medicamentos, cuidados críticos, preparaciones farmaceúticas, unidad de cuidados intensivos, erupciones cutáneas

Summary:

Cutaneous diseases triggered by medications are common and usually harmless, but some of the less frequent variations can be life threatening. Some of the diseases in this category are the spectrum of Stevens-Johnson syndrome/ toxic epidermal necrolysis and drug reaction with eosinophilia and systemic symptoms syndrome.

The rare occurrence of these diseases has led to low levels of knowledge on its clinical presentation, diagnosis and treatment by medical staff on intensive care units, which can be associated with attention delays and negative impact on morbimortality.

This article reviews the above conditions, and describes its association with medications frequently used on intensive care units, as well as its pathophysiology, clinical presentation and treatment.

Key words:

Stevens-Johnson syndrome, drug hypersensitivity syndrome, critical care, pharmaceutical preparations, intensive care units

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Referencias

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