Inhibidores de bomba de protones vs. antagonistas del receptor 2 de histamina en la protección gástrica en el paciente anticoagulado: ¿qué ha definido la evidencia?

Autores/as

  • Angie S. Duarte-Duran Universidad de Santander, Bucaramanga, Colombia https://orcid.org/0009-0000-5903-203X
  • Federico Arango-Moreno Universidad del Quindío, Armenia, Colombia https://orcid.org/0009-0001-3414-7639
  • Karen D. Palomino-Mendoza Fundación Universitaria San Martín, Bogotá, Colombia https://orcid.org/0009-0006-2562-4698
  • Zaira Y. Rincón-Lozano Universidad Cooperativa de Colombia, Villavicencio, Colombia
  • Laura D. Rojas-Torres Pontificia Universidad Javeriana, Bogotá, Colombia
  • Gianfranco Buvoli-Macareno Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia https://orcid.org/0009-0007-2241-3534
  • Angélica M. Rodríguez-López Fundación Universitaria Juan N Corpas, Bogotá, Colombia https://orcid.org/0000-0002-3288-511X
  • Michael G. Ortega-Sierra Universidad Centroccidental Lisandro Alvarado - Hospital Central Antonio María Pineda, Barquisimeto, Venezuela

DOI:

https://doi.org/10.35839/repis.8.1.1895

Palabras clave:

inhibidores de la bomba de protones, antagonistas de los receptores h2 de la histamina, antiulcerosos, anticoagulantes, literatura de revisión como asunto

Resumen

Objetivo: evaluar la evidencia más reciente sobre la diferencia de la gastroprotección generada por los inhibidores de bomba de protones (IBP) y antagonistas del receptor de histamina 2 (ARH2) en el paciente anticoagulado, así como del riesgo de sangrado gastrointestinal asociado. Métodos: revisión narrativa. Se realizó una búsqueda bibliográfica en las bases de datos PubMed, ScienceDirect, Web of Science, y MEDLINE. Resultados: dentro de los mecanismos descritos que explican un sangrado en el tracto gastrointestinal, se encuentran el daño a mucosa, alteraciones en el pH local, inhibición plaquetaria y alteración de factores de la coagulación, y lesiones vasculares. Dependiendo del grupo farmacológico, los anticoagulantes pueden actúan a nivel de diferentes dianas de la vía de la coagulación, alterando los factores involucrados en esta vía, y pudiendo desencadenar sangrado. Por su parte, los antisecretores gástricos, tienen como objetivo inhibir o reducir la secreción de ácido gástrico por medio de la interacción con sistemas enzimáticos, alterando el pH local. De esta forma, estos fármacos influyen sobre el riesgo de sangrado. No obstante, la evidencia más reciente demuestra que los IBP reducen la probabilidad de sangrado gastrointestinal hasta en un 33%, comparado con los ARH2, sin impactar en otros desenlaces como mortalidad u hospitalización. Conclusión: aunque la evidencia es escasa y heterogénea, se pudo observar mayor respaldo científico y beneficio gastroprotector contra la frecuencia de sangrado gastrointestinal, con el uso de IBP comparado a ARH2, en pacientes anticoagulados que concomitantemente, utilizan antisecretores gástricos.

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Publicado

2024-03-30

Cómo citar

1.
Duarte-Duran AS, Arango-Moreno F, Palomino-Mendoza KD, Rincón-Lozano ZY, Rojas-Torres LD, Buvoli-Macareno G, Rodríguez-López AM, Ortega-Sierra MG. Inhibidores de bomba de protones vs. antagonistas del receptor 2 de histamina en la protección gástrica en el paciente anticoagulado: ¿qué ha definido la evidencia?. Rev Peru Investig Salud [Internet]. 30 de marzo de 2024 [citado 22 de mayo de 2024];8(1):e1895. Disponible en: https://revistas.unheval.edu.pe/index.php/repis/article/view/1895

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