Interacciones medicamentosas

Interacciones
Hoy os queremos acercar un tema sobre el que muchos pacientes sienten curiosidad e incluso, en algunos casos, miedo. Hablamos de las interacciones medicamentosas. Vamos a hacer un repaso sobre qué son y cómo podemos prevenirlas.
CONCEPTO

Una interacción farmacológica se puede definir como «cualquier alteración, en el sentido que sea, de la respuesta previsible a la acción de un fármaco, que sea consecuencia de la acción concurrente en el organismo de otra sustancia química no producida por el mismo».

En esta definición caben las interacciones producidas entre dos o más medicamentos, así como aquellas desarrolladas entre un medicamento y productos tan diversos como alimentos, pesticidas o cualquier otra sustancia susceptible de estar en contacto directo con el ser humano (tabaco, alcohol, etc.).

Es decir, la probabilidad de sufrir interacciones o reacciones  adversas  aumenta exponencialmente  con el número de fármacos  que tomamos.

TIPOS DE INTERACCIONES

Las diferentes formas de producción de interacciones pueden clasificarse en tres grupos.

  1. Interacciones físico-químicas

Son incompatibilidades físico-químicas y las únicas  que son independientes de lo que nosotros como pacientes hagamos. En general, se producen fuera del organismo, y son las que impiden mezclar dos o más fármacos en una misma solución. Pueden ser físicas cuando se produce una incompatibilidad de solubilidad o de tipo químico cuando por ejemplo uno de los fármacos provoca un cambio de pH que pueda afectar al otro.

 2. Interacciones farmacodinámicas
Antes de nada, cuando hablamos de farmacodinámica  o mecanismo de acción nos referimos a la forma de actuar del medicamento en nuestro organismo, y por tanto, estas interacciones conllevan una modificación en la respuesta del órgano efector.

Como  consecuencia aparecen fenómenos de sinergia (aumento de la acción de dos medicamentos que se han tomado a la vez), antagonismo (dos medicamentos que tienen acciones opuestas) o potenciación (la acción de uno de los medicamentos que hemos tomado aumenta debido a otro) del fármaco afectado por la interacción.

En  general, los   fármacos del  mismo  grupo o familia  suelen ocasionar el mismo tipo de interacciones farmacodinámicas, este tipo de interacciones son más predecibles y podrían evitarse si se conocen las acciones  farmacológicas de las  medicinas que  se prescriben.

3Interacciones farmacocinéticas

Son la  que se producen cuando el fármaco desencadenante  de la  interacción altera  la  absorción intestinal,  la distribución por el organismo, el metabolismo que sufre el medicamento dentro del organismo o la eliminación del fármaco, generalmente por el riñón. De modo que la consecuencia de dicha interacción será un aumento o una disminución de la cantidad de fármaco disponible  para actuar a nivel del órgano. Las  interacciones  a este nivel pueden  ser esperadas pero los síntomas que nos producen son difíciles de predecir.

¿Qué medidas existen para disminuir las interacciones medicamentosas?

Existen una serie de medidas que pueden reducir la probabilidad de que se produzcan estas interacciones. Las más importantes son llevadas a cabo por su médico y farmacéutico, de tal manera que no afecten al paciente directamente. Hemos de tener en cuenta que no todos los fármacos nos producirán interacciones y que sólo aquellos con reacciones especialmente peligrosas son los que se controlan estrechamente, por lo que no hemos de alarmarnos. Algunas acciones que podemos realizar pueden ser:

  • Informar a su médico en todo momento de los tratamientos “alternativos” que se realizan, estos incluyen: plantas medicinales y sus extractos, dietoterápicos, complementos alimenticios, homeopatía, etc. Muchas veces estos son causa de una interacción evitable, que no se realiza por no informar a nuestro médico o farmacéutico.
  • Existen determinados alimentos con altas probabilidades de interacción medicamentosas, como pueden ser el pomelo, el regaliz, y las bebidas alcohólicas.

De esta manera, la mejor forma de evitar estas interacciones es informar de todo lo que tomamos a nuestros profesionales de la salud, para que ellos puedan tomar las decisiones con la mayor información posible.


 Daniel Ruiz Sánchez
Licenciado en Farmacia. Estudiante de 6º curso de Grado en Medicina

Andrea Villamar Carromero
Estudiante de 6º curso de Grado en Medicina

 Elpidio García Ramón
Médico de Familia, C. S. Arturo Eyries, Valladolid

 

REFERENCIAS

  • Consejo General de Colegios Oficiales de Farmacéuticos. Base de datos del medicamento (BOT).
  • De Blas Matas, B Laredo Velasco, LM Vargas Castrillón. Interacciones de los fármacos más consumidos. Información terapéutica del Sistema Nacional de Salud Vol 28 nº1 2004,
  • Flórez J. Farmacología humana. Ed. Masson S.A. Barcelona 2003.
  • Interacciones farmacológicas. Primera Edición. Ed Pharma Editores S.L 2004.

 
Revisado: abril 2017

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