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Vol. 29. Issue 3.
Pages 109-115 (April 1993)
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Vol. 29. Issue 3.
Pages 109-115 (April 1993)
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Yatrogenia de la terapéutica corticoidea y de los corticoides inhalados en el tratamiento de los enfermos respiratorios
Iatrogenesis of corticoid therapy and inhaled corticoids in the treatment of patients with respiratory disease
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M. Luengo Planas, C. Picado Vallés
Servei de Pneumologia. Hospital Clínic. Facultat de Medicina. Barcelona
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Es bien conocido que el tratamiento continuo con glucocorticoides se asocia en un número considerable de pacientes a múltiples efectos secundarios. A lo largo de su historia, y dado que son agentes con una potencia antiinflamatoria muy importante, han sufrido variaciones en cuanto a su prescripción, pasando de una utilización demasiado “generosa” lo que provocaba la aparición de efectos secundarios importantes, a una restricción de su uso, a veces, más de lo médicamente necesario. Actualmente, sus indicaciones y pautas de administración están bien establecidas, y aunque la yatrogenia existe y en algunos casos produciendo una morbilidad importante, la larga lista de efectos secundarios se reducen a unos pocos, entre los que destacan: 1. Osteopenia (disminución de la masa ósea) con aumento en la prevalencia de fracturas fundamentalmente vertebrales. 2. Cataratas, en su localización subcapsular posterior. 3. Miopatía. 4. Alteraciones cutáneas (púrpura y adelgazamiento de la dermis).

Long term treatment with glucocorticoids is associated with multiple secondary effects in an appreciable number of patients. This is why throughout their history these drugs, as therapeutic agents, have undergone variations in regards to use, due, on one hand, to their important therapeutic action making their usage too “generous” in some diseases, and on the other hand, to the appearance of side effects of considerable importance which restricted their use to less than what may have been medically necessary. At present, the indications and schedules of administration are well established and although iatrogenesis exists, and in some cases produces signiflcant morbidity, tlie long list of secondary effects has been reduced to only a few, such as osteopenia with an increase in the prevalence of vertebral fractures, formation of posterior subcapsular cataracts, myopathy and cutaneous alterations (purpura and thinning of the dermis).

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Copyright © 1993. Sociedad Española de Neumología y Cirugía Torácica
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