RESUMEN
La hepatotoxicidad es una complicación infrecuente tras el empleo de propofol, que puede ser potencialmente grave en caso de no realizarse un diagnóstico precoz. El propofol es un fármaco cada vez más empleado en la práctica diaria no solo en cirugía sino también en la sedación de procedimientos invasivos ambulatorios tales como la endoscopia. Acarbosa es un fármaco clásico en el tratamiento de la diabetes tipo 2 en estadios iniciales que puede causar de forma infrecuente hepatitis tóxica. Se presenta el caso de una paciente que sufrió una hepatitis aguda secundaria al empleo de propofol como anestesia oftalmológica, hepatitis probablemente potenciada por el uso previo de acarbosa. El cuadro se diagnosticó de forma precoz y se resolvió sin complicaciones. El conocimiento de esta complicación en el ámbito de la anestesiología se revela cada vez más importante para mejorar la valoración preanestésica de los pacientes que vayan a ser sedados con propofol y así evitar en lo posible su aparición (AU)
Hepatotoxicity is a rare complication following the use of propofol and can be potentially serious if an early diagnosis is not made. Propofol is being increasingly used in daily practice, not only in surgery, but also in outpatient sedation procedures, such as endoscopy. Acarbose is a well-known drug used in type 2 diabetes treatment, particularly in the early phase. A case is reported on a patient who suffered an acute hepatitis secondary to the use of propofol in ophthalmology surgery, a hepatitis probably enhanced by prior use of acarbose, a drug that also can cause hepatotoxicity. An early diagnosis and it was resolved without complications. This case could contribute to improve pre-anesthetic evaluation of patients who will be undergoing sedation with propofol in order to avoid the possible appearance of hepatitis (AU)
Asunto(s)
Humanos , Femenino , Adulto , Acarbosa/administración & dosificación , Acarbosa/efectos adversos , Acarbosa/farmacocinética , Propofol/administración & dosificación , Propofol/efectos adversos , Propofol/farmacología , /complicaciones , /diagnóstico , Hepatitis/complicaciones , Anestesia/métodos , Acarbosa/metabolismo , Hepatitis/tratamiento farmacológico , Acarbosa/toxicidad , Anestesia/normas , Propofol/farmacocinética , Propofol/uso terapéutico , Diagnóstico Precoz , Anestesiología/ética , Anestesiología/métodos , Anestesiología/normasRESUMEN
Hepatotoxicity is a rare complication following the use of propofol and can be potentially serious if an early diagnosis is not made. Propofol is being increasingly used in daily practice, not only in surgery, but also in outpatient sedation procedures, such as endoscopy. Acarbose is a well-known drug used in type 2 diabetes treatment, particularly in the early phase. A case is reported on a patient who suffered an acute hepatitis secondary to the use of propofol in ophthalmology surgery, a hepatitis probably enhanced by prior use of acarbose, a drug that also can cause hepatotoxicity. An early diagnosis and it was resolved without complications. This case could contribute to improve pre-anesthetic evaluation of patients who will be undergoing sedation with propofol in order to avoid the possible appearance of hepatitis.
Asunto(s)
Acarbosa/efectos adversos , Anestésicos Intravenosos/efectos adversos , Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Hipoglucemiantes/efectos adversos , Propofol/efectos adversos , Acarbosa/farmacocinética , Acarbosa/uso terapéutico , Anciano , Anestesia Intravenosa , Anestésicos Intravenosos/farmacocinética , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Interacciones Farmacológicas , Femenino , Humanos , Hipoglucemiantes/farmacocinética , Hipoglucemiantes/uso terapéutico , Implantación de Lentes Intraoculares , Facoemulsificación , Propofol/farmacocinética , Factores de TiempoAsunto(s)
Humanos , Femenino , Persona de Mediana Edad , Hipernatremia/complicaciones , Hipernatremia/diagnóstico , Hidrocefalia/complicaciones , Hidrocefalia/diagnóstico , Deshidratación/complicaciones , Hipopituitarismo/complicaciones , Hipopituitarismo/diagnóstico , Hipernatremia/fisiopatología , Hipernatremia , Hidrocefalia , Concentración Osmolar , Infecciones Urinarias/complicaciones , Infecciones Urinarias/terapia , Hidrocortisona/uso terapéutico , Ventrículos CerebralesRESUMEN
Two series of analogues of riluzole, a blocker of excitatory amino acid mediated neurotransmission, have been synthesized: monosubstituted 2-benzothiazolamines and 3-substituted derivatives. Of all the compounds prepared in the first series, only 2-benzothiazolamines bearing alkyl, polyfluoroalkyl, or polyfluoroalkoxy substituents in the 6-position showed potent anticonvulsant activity against administration of glutamic acid in rats. The most active compounds displaying in vivo "antiglutamate" activity were the 6-OCF(3) (riluzole), 6-OCF(2)CF(3), 6-CF(3), and 6-CF(2)CF(3) substituted derivatives with ED(50) values between 2.5 and 3.2 mg/kg i.p. Among the second series of variously substituted benzothiazolines, compounds as active as riluzole or up to 3 times more potent were identified in two series: benzothiazolines bearing a beta-dialkylaminoethyl moiety and compounds with an alkylthioalkyl chain and their corresponding sulfoxides and sulfones. The most potent derivatives were 2-imino-3-(2-methylthio)- and 2-imino-3-(2-methylsulfinyl)-ethyl-6-trifluoromethoxybenzothiazolines (61 and 64, ED(50) = 1.0 and 1.1 mg/kg i.p., respectively). In addition, intraperitoneal administration of some of the best benzothiazolines protected mice from mortality produced by hypobaric hypoxia.