17-teórico 17 de farmacología general 24

8/18/2019 17-Teórico 17 de Farmacología General 24

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TEÓRICO 17 DE FARMACOLOGÍA GENERAL 20/05/04.

Bueno, ho !"#o$ " !e% &o$ 'e#"$, e( )%*#e%o e$ +"$'%o*n'e$'*n"(, e( $e+un&o e$ %en"(. Bueno, en %e("*-n "

"%#"o(o+" &e( '%"'o +"$'%o*n'e$'*n"(, &e$&e e( )un'o &e !*$'" "%#"o(-+*o, ("$ un*one$ )%*n*)"(e$, $on

e%e*-n +$'%*".

3-#*'o '#e$*$.

Mo'*(*&"& *n'e$'*n"( e6)u($*-n &e ("$ hee$.E$ #u *#)o%'"n'e ue u$'e&e$ ono8"n u(e$ $on ("$ *ne%!"*one$ ("$ $e%e*one$ ho%#on"(e$ ue on'%o("n e( '%"

+"$'%o*n'e$'*n"(, )"%" )o&e% en'en&e% ("$ un*one$ *$*o(-+*"$, (o$ )%oe$o$ )"'o(-+*o$ e( ee'o ue '*enen (o

%#"o$, $o9%e e$'e '%"'o.

En %e("*-n "( on'%o( ne%!*o$o, e$'e e$' &"&o )o%

E( )(e6o &e Aue%9"h #*en':%*o.

E( )(e6o &e Me*$$ne% $u9#uo$o.

E$'o$ )(e6o$, '*enen *9%"$ )"%"$*#)'*"$ )%e+"n+(*on"%e$ &e( !"+o ue (*9e%"n "e'*(o(*n" o(*n:%+*"$ $o

e6*'"'o%*"$. A $u !e8, '*enen *9%"$ )o$'+"n+(*on"%*"$ $*#)'*"$ ue (*9e%"n no%"&%en"(*n" ue !"n " *ne%!"% !"$o$"n+uneo$, #;$u(o (*$o :(u("$ +("n&u("%e$.

E$'o$ )(e6o$, on$'*'uen e( $*$'e#" ne%!*o$o en':%*o. A&e#$ &e e$'"$ :(u("$, e6*$'en o'%"$ ue (*9e%"n o'%

neu%o'%"n$#*$o%e$ o'%"$ $u$'"n*"$

Neu%on"$ $*#)'*"$ no%"&%en"(*n" %ee)'o%e$ β "&%en:%+*o$.

Neu%on"$ )"%"$*#)'*"$ "e'*(o(*n" %ee)'o%e$ #u$"%n*o$.

Neu%on"$ no "&%en:%+*"$ no o(*n:%+*"$ $e%o'on*n", )u%*n"$, ):)'*&o$ 3I


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L" e$o"+*'*$ )o% %e(u=o.

L"$ :(u("$ $e%e'o%*"$ ue enon'%"#o$ en e( e$'-#"+o $on

L"$ :(u("$ ):)'*"$ o )%*n*)"(e$ ue on'*enen )e)$*n-+eno.

L"$ :(u("$ )"%*e'"(e$ u o6*n'*"$ (*9e%"n *&o (o%h&%*o "'o% *n'%n$eo.

E$ en e$'"$ :(u("$ en &on&e !"#o$ " en'%"% e( e$'u&*o.

3e"#o$ e( $*+u*en'e e$ue#":

Tene#o$ e( e$ue#" &e un" :(u(" )"%*e'"(. E$'"$ :(u("$, " '%"!:$ &e &*-6*&o &e "%9ono "+u", )o% #e&*o &e un"

en8*#" ue e$ (" "nh*&%"$" "%9-n*", o%#"n e( *&o "%9-n*o, e( u"(, (*9e%" un )%o'-n (*9e%" 9*"%9on"'o. E$e

9*"%9on"'o e$ *n'e%"#9*"&o h"*" e( )("$#", )o% *one$ (o%u%o$. Bueno, u"n&o e$' ou%%*en&o e( )%oe$o &e ("

&*+e$'*-n, e( 9*"%9on"'o e$ (*9e%"&o "( )("$#", en'one$, (" $"n+%e !eno$" ue )%o!*ene &e( e$'-#"+o, '*ene un )? #uho

#"$ 9$*o ue (" $"n+%e "%'e%*"(, e$'o e$ (o ue $e onoe on e( no#9%e &e #"%e" "("(*n". )o'"$*o AT<

&e)en&*en'e, (" u"(, (*9e%" )%o'one$ " (" (u8 +$'%*" e *n'%o&ue *one$ " (" :(u(". En %e("*-n " (" $e%e*-n +$'%*",

:$'", '*ene '%e$ e'")"$ F"$e e(*" #e&*"&" )o% e( ne%!*o !"+o o#o %e$u('"&o &e (" "'*!*&"& &e( NC e$'*#u("&o )o% $"9o%e$

o(o%e$.

F"$e +$'%*" #e&*"&" )o% %e(e=o$ ne%!*o$o$ (o"(e$ e$'*#u("*-n u#*" #en*". E$'" $e )%o&ue u"n&o

(o$ "(*#en'o$ ((e+"n "( e$'-#"+o.

F"$e *n'e$'*n"( #e&*"&" )o% e$'*#u("*-n u#*" &e( &uo&eno. E$ &e*%, e$ u"n&o (o$ "(*#en'o$ $e h"n

&e+%"&"&o )"$"n "( &uo&eno.

Bueno, (o$ '%e$ e$'#u(o$ )%*n*)"(e$ ue !"n " e$'*#u("% (" $e%e*-n +$'%*" $on

L" +"$'%*n" e$ un" ho%#on".

L" h*$'"#*n" $e (" on$*&e%" un" ho%#on" (o"(.

L" "e'*(o(*n" ue e$ un neu%o'%"n$#*$o%.

3e"#o$ e( $*+u*en'e e$ue#"

Tene#o$ un" :(u(" )"%*e'"( un" :(u(" e)*'e(*"(. En'one$, $o9%e (" :(u(" )"%*e'"( !" " "'u"% +"$'%*n", h*$'"#*n"

"e'*(o(*n". L" +"$'%*n", o#o h"9"#o$ !*$'o, e$ (*9e%"&" )o% ("$ :(u("$ G ue $e enuen'%"n en e( "n'%o, !*"="n )o% e(

'o%%en'e $"n+uneo h"$'" ("$ :(u("$ )"%*e'"(e$. L" +"$'%*n" )ue&e $e% (*9e%"&" )o% &*!e%$o$ e$'#u(o$, '"( e$ e( "$o &e (o$

)%o&u'o$ &e (" &*+e$'*-n &e ("$ )%o'en"$ "#*no*&o$ ):)'*&o$ )eue@o$. G"$'%*n" "';" $o9%e %ee)'o%e$

&eno#*n"&o$ %ee)'o%e$ G, ue $e enuen'%"n

o9%e :(u("$ e9"&"$ ue on'*enen h*$'"#*n", !"n " )%o&u*% (" (*9e%"*-n &e h*$'"#*n". L" h*$'"#*n", "';"

$o9%e %ee)'o%e$ h*$'"#*n:%+*o$ '*)o 2 ?2, )o% un" !" ue e$ &e)en&*en'e &e( AM


3/18

En u"n'o " "e'*(o(*n", :$'" )ue&e "'u"%

o9%e ("$ :(u("$ e9"&"$ )%o&u*en&o (" (*9e%"*-n &e h*$'"#*n".

o9%e (" :(u(" )"%*e'"(, $o9%e %ee)'o%e$ #u$"%n*o$ '*)o 2 o '*)o M2 o M.

Ae'*(o(*n", '"#9*:n "'*!" un" !" &e)en&*en'e &e C", (o ue !" " *n"(*8"% en (" "'*!"*-n &e (" 9o#9" )%o'-n>)o'"$

AT


4/18

un" nue!" 9o#9" &e )%o'one$ )"%" ue $e (*9e%en )%o'one$ " (" (u8 +$'%*". E$'"$ &%o+"$ $e "*n*$'%"n un" !e8 "(

&" $u "*-n )e%&u%" )o% &o$ o '%e$ &"$, $*n e#9"%+o, en (o$ '%"'"#*en'o$, $e %eo#*en&" h"e% un"

"*n*$'%"*-n &*"%*" )"%" #"n'ene% (o$ n*!e(e$ on$'"n'e$ &e e$'"$ &%o+"$ en e( o%+"n*$#o. Lo$ ee'o$

$eun&"%*o$ $on (o$ %e("*on"&o$ on (" )o$*9(e "(o%h*&%*" ue +ene%"%"n (o$ '%"'"#*en'o$ )%o(on+"&o$.

O'%o '*)o &e '%"'"#*en'o, e$'" 9"$"&o en (" "*n*$'%"*-n &e "n'**&o$ '"(e$ o#o e( h*&%-6*&o &e M+, e(

'%*$*(*"'o &e M+, e( +e( &e h*&%-6*&o &e "(u#*n*o, e( 9*"%9on"'o &e N", e'. Lo ue no $e %eo#*en&", e$ e( u$o &e

"n'**&o$ ue on'en+"n "(*o, " ue e$'o$ e$'*#u("n (" $e%e*-n +$'%*". En %e("*-n " )%o'e'o%e$ &e (" #uo$", 'ene#o$ " $u%"("'o, 9*$#u'o &e &**'%"'o '%*)o'$*o, "%9eno6o(on", ue

)%o&uen un" )%o'e*-n &e '*)o $*", )o% e=e#)(o, en e( "$o &e $u%"("'o, e$'e e$' o%#"&o )o% $u%o$"

$u("'"&" "(u#*n*o u"n&o ((e+" " (" #uo$" &e( e$'-#"+o, $e "&h*e%e $o9%e (" ;(e%" &e e$'" o%#", ("

)%o'e+e.

Bueno, en %e("*-n " (o$ vómitos, 'ene#o$ '%e$ e'")"$

N"u$e"$ $en$"*-n en (" +"%+"n'" o %e+*-n e)*+$'%*" "(e%'"n&o "( !-#*'o. E$' "%"'e%*8"&" )o% '"u*"%&*",

$u&o%"*-n, %e$)*%"*-n *%%e+u("%.

A%"&"$ #o!*#*en'o &e #;$u(o$ 'o%*o$ "9&o#*n"(e$ ue +ene%"n e( !-#*'o. 3o#*'o ee*-n o e6)u($*-n &e( on'en*&o +$'%*o " '%"!:$ &e (" 9o".

E( !-#*'o e$' on'%o("&o )o%

E( en'%o &e( !-#*'o on'%o(" #o!*#*en'o$ *n'e%%e("*on"&o$ &e #;$u(o$ (*$o$ e$'%*"&o$ )"%'e 9"=" &e( 9u(9o,

en (" o%#"*-n %e'*u("%.

on" +"'*((o u*#*o%ee)'o%" %e" )o$'%e#" &e (" 9"$e &e( u"%'o !en'%u(o. E$'" 8on", no e$' )%o'e+*&" )o% ("

9"%%e%" he#"'oene(*", )o% (o '"n'o, )ue&en ((e+"% 'o&o '*)o &e $u$'"n*"$ " e$'" %e+*-n. E$'" %e+*-n "&e#$,

e$' %e("*on"&" on (" *ne'o$*$, ue e$ e( #"%eo o"$*on"&o )o% &*!e%$o$ '*)o$ &e #o!*#*en'o$. L" *ne'o$*$

o#*en8" en (" 8on" ("9e%n'*", )"$" " (" %e+*-n !e$'*9u("%, (ue+o, (" %e+*-n !e$'*9u("%, " '%"!:$ &e (" (*9e%"*-n&e "(+un"$ $u$'"n*"$ ue 'o&"!" no$ e onoen, !" " e$'*#u("% (" 8on" &e +"'*((o u*#*o%ee)'o%".

En %e("*-n " (o$ neu%o'%"n$#*$o%e$ ue e$'n *n!o(u%"&o$ en (" +ene%"*-n &e( !-#*'o, $on !"%*"&o$ "e'*(o(*n",

no%"&%en"(*n", &o)"#*n", $e%o'on*n", h*$'"#*n", +(u'"#"'o, GABA, AT?T ue '"#9*:n e$'n en e( *n'e$'*no, en e$'e "$o,

u$"%e#o$ "n'"+on*$'"$ $e%o'on*n:+*o$.

En e( '%"'o $o(*'"%*o nu(eu$ "#9*+uu$ 'ene#o$ %ee)'o%e$ #u$"%n*o$, e$'o$ &o$, o%#" )"%'e &e( en'%o &e(

!-#*'o. $"%e#o$ "n'"+on*$'"$ o(*n:%+*o$.

En e( '%"'o $o(*'"%*o, '"#9*:n 'ene#o$ %ee)'o%e$ )"%" h*$'"#*n" ?1, )o% (o '"n'o, u$"%e#o$ "n'"+on*$'"$

h*$'"#*n:%+*o$.

Bueno, !e#o$ (" $*+u*en'e *(#*n" *+u%" 1>

Tene#o$ (o$ &*!e%$o$ e$'#u(o$ ue )ue&en ((e+"% " )%o&u*% un !-#*'o. Tene#o$ ue )ue&en $e%

4


5/18

Do(o%e$ *n'en$o$, !*$*one$ u o(o%e$ %e)u($*!"$, "'o%e$ e#o*on"(e$ !"n " e$'*#u("% "e%en'e$ $en$o%*"(e$ !"

&e( NC, !"n " *n'e+%"%$e en en'%o$ $u)e%*o%e$ !"n " en!*"% *no%#"*-n h"*" e( en'%o &e( !-#*'o.

C*ne'o$*$ o#*en8" en e( ("9e%*n'o, )"$" " (o$ n;(eo$ !e$'*9u("%e$, &e "((, )"$" " (" 8on" &e +"'*(

u*#*o%ee)'o%", (ue+o "( en'%o &e( !-#*'o.

E( !-#*'o '"#9*:n )ue&e $e% )%o&u*&o )o% 'o6*n"$ en&-+en"$ o %#"o$, ue " '%"!:$ &e (" $"n+%e, ((e+"n "

8on" &e +"'*((o u*#*o%ee)'o%", )"$"n "( en'%o &e( !-#*'o. T"#9*:n )ue&e $e% ue )%o&u8"n (" "('e%"*-n &

"+en'e$ e#e'-+eno$ o#o )o% e=e#)(o $e%o'on*n", )%o$'"no*&e$ %"&*"(e$ (*9%e$, ue "';"n &*%e'"#en'e $o9(" 8on" &e +"'*((o u*#*o%ee)'o%" o $o9%e "e%en'e$ !*$e%"(e$.


6/18

An'"+on*$'"$ $e(e'*!o$ )"%" %ee)'o%e$ &e $e%o'on*n" 5>?T on&"n$e'%-n, +%"n*$e'%-n. B(oue"n (o$ %ee)'o%e$ 5>

?T ue $e enuen'%"n en (" 8on" &e( +"'*((o u*#*o%ee)'o%", '"#9*:n $e u'*(*8"n en )"*en'e$ ue e$'n

%e*9*en&o u*#*o'e%")*". No "';" $o9%e %ee)'o%e$ D 2. En u"n'o " (o$ ee'o$ "&!e%$o$ 'ene#o$ e"(e",

#"%eo$, $o#no(en*", no )o$ee ee'o$ e6'%")*%"#*&"(e$. on &e o$'o e(e!"&o.

C"n"9*no*&e$ &%on"9*no(, n"9*(one. "n'*o(*n:%+*o$ *(*8*n",

#e(*8*n". T%"'"#*en'o$ u*#*o'e%"):u'*o$ en un*-n &e (" $e!e%*&"& &e( '%"'"#*en'o, $e !"n " e(e+*% &*$'*n'o$ '*)o$ &e

'%"'"#*en'o$ "n'*e#:'*o$. e!e%o$ "n'"+on*$'"$ D2 5>?T, "n'"+on*$'"$ 5>?T. Mo&e%"&o$ "n'"+on*$'"$ D2,

o%'*o$'e%o*&e$, "n"9*no*&e$. Mn*#"#en'e ee'*!o$ "n'"+on*$'"$ ?1, "n'"+on*$'"$ #u$"%n*o$,

9en8o&*"e)*n"$.

5>?T, "n'"+on*$'"$ 5>?T.

3:%'*+o$ "n'"+on*$'"$ #u$"%n*o$ E$o)o("#*n", "n'*h*$'"#*n:%+*o$>"n'*o(*n:%+*o$ &%"#"#*ne.

Aho%" !"#o$ " h"9("% &e &*"%%e"$ on$'*)"*-n.

En %e("*-n " ("$ &*"%%e"$, ("$ &*"%%e"$ $e &e*nen o#o un &e$9"("ne en (" "9$o%*-n $e%e*-n &e ? 2O e(e'%o(*'o$,"%"'e%*8"&" )o% un "u#en'o en (" %euen*" on$*$'en*" &e ("$ &e)o$**one$.


7/18

T%"'"% &e #"n'ene% (" h*&%"'"*-n (o$ e(e'%o(*'o$, e$ &e*%, no "*n*$'%"% $o("#en'e "+u", $*no '"#9*:n un

#e8(" &e +(uo$" on C(N" "#*no*&o$, )o%ue " n*!e( &e( (eon, e6*$'e un '%"n$)o%'e N">+(uo$", en'one

u"n&o en'%" (" +(uo$", *n+%e$" e( N" '"#9*:n e$ "$*#*("&o.

O'%" o$" #u *#)o%'"n'e, e$ )%o&u*% "#9*o$ " n*!e( &e (" &*e'".

Co#o en "(+uno$ "$o$ $on )%o&u*&"$ )o% "+en'e$ 9"'e%*"no$, $e u'*(*8"n "n'*9*-'*o$ o "n'**ne*o$o$.

O'%o '*)o &e '%"'"#*en'o, e$ " '%"!:$ &e "+en'e$ ue *nh*9en (" #o'*(*&"& *n'e$'*n"(, o#o )o% e=e#)(o

• O)*o*&e$ &e%*!"&o$ (o$ #"$ u$"&o$ $on o&en" (o)e%"#*&", ue "';"n '"n'o " n*!e( en'%"(, o#o "

'"#9*:n " n*!e( )e%*:%*o, Lo ue h"en, e$ &*$#*nu*% (" #o'*(*&"&, )o% (o '"n'o, "u#en'" e( '*e#)o &

on'"'o en'%e e( on'en*&o *n'e$'*n"( ("$ )"%e&e$, "u#en'" (" "9$o%*-n, e$ &e*%, &*$#*nue

)e%*$'"('*$#o &e#o%" e( '%n$*'o *n'e$'*n"(, )%o(on+"n&o e( on'"'o (" "9$o%*-n. L" )%*n*)

&e$!en'"=" &e e$'o$ %#"o$, e$ ue '*enen un )o&e% "&*'*!o *#)o%'"n'e.

• D%o+"$ "n'*o(*n:%+*"$ "'%o)*n". T"#9*:n )%o(on+" e( '*e#)o &e on'"'o en'%e e( on'en*&o *n'e$'*n"(

("$ )"%e&e$. E$ &e*%, h" un 9(oueo &e( 'ono !"+"( un" )%o(on+"*-n &e( '%n$*'o *n'e$'*n"(. E$'

on'%"*n&*"&o$ en +("uo#", ene%#e&"&e$ "%&""$ u%o)"'"$ o9$'%u'*!"$.

O'%o '*)o &e '%"'"#*en'o e$ on e( u$o &e "&$o%9en'e$, '"( e$ e( "$o &e "o(n, )o(*"%9o*(, "%9-n )e'*n

"&$o%9en "+u" #*%oo%+"n*$#o$, "u#en'"n (" #"$" &e ("$ hee$.

A+en'e$ "n'*$e%e'o%*o$ $e u'*(*8"n )%*n*)"(#en'e )"%" )%e!en*% ("$ &*"%%e"$ &e( !*"="n'e, )o% e=e#)(o, e( $"(**("

&e 9*$#u'o.

An'*9*-'*o$ 'e'%"*(*n"$.

Aho%" !"#o$ " h"9("% &e on$'*)"*-n. L" &e*n**-n &e on$'*)"*-n, !" " &e)en&e% &e "&" *n&*!*&uo, )e%o en +ene%"(,

(" &e*ne o#o un" &*$#*nu*-n en (" %euen*" on$*$'en*" &e ("$ &e)o$**one$. No e$ un" ene%#e&"& $*no ue e$ u

$n'o#".

L"$ "u$"$ )%*n*)"(e$ $on

D*e'" *n")%o)*"&" 9"=o on'en*&o &e *9%"$, " (o ue $e $u#" (" "('" &e "'*!*&"& $*".

T%"$'o%no$ &e( '%"'o +"$'%o*n'e$'*n"( o(on *%%*'"9(e, &*!e%'*u(*'*$, "%*no#" &e o(on, he#o%%o*&e$, *$u%"$.

T%"$'o%no$ en&-%*no$ h*)o'*%o*&*$#o, eo%o#o*'o#".

T%"$'o%no$ #e'"9-(*o$ &*"9e'e$, h*)e%"(e#*".

C"u$"$ *$*o(-+*"$ e#9"%"8o.

$o &e "(+un"$ &%o+"$ o)*o*&e$, "n'*o(*n:%+*o$, "n'**&o$ A(, C".

En u"n'o "( '%"'"#*en'o, (o )%*#e%o ue $e &e9e h"e%, e$ 'o#"% un" on&u'" -)'*#" en (" &*e'", e$ &e*%, "#9*o$ en &*e'", "u#en'"n&o e( on$u#o &e *9%"$ e%e"(e$, !e%&u%"$ %u'"$, e$'o, &e9e *% "o#)"@"&o &e un "u#en'o en (

"'*!*&"& $*". * on e$'" )%*#e%" )"%'e, no $e o9$e%!"n %e$u('"&o$, $e )"$" " (o$ %#"o$. Den'%o &e e$'o$ 'ene#o$


8/18

• L"6"n'e$ e#o(*en'e$ '"( e$ e( "$o &e( &ou$"'o, e( u"( e$ un $u%"'"n'e )%e!*ene (" on$'*)"*-n.

• L"6"n'e$ o$#-'*o$ o#o (" ("'u(o$" &*$"%*&o e( $o%9*'o( #ono$"%*&o, ue (o ue h"en, e$

%e'ene% "+u" en e( o(on, )o% ee'o o$#-'*o, en'one$, '"#9*:n, en *e%'" #"ne%", "u#en'"n e( !o(u#en

&e ("$ hee$, e$'o !" " "u#en'"% e( )e%*$'"('*$#o. En u"n'o " (" (ehe &e #"+ne$*o, :$'", o%#" $"(e$ &e

$u("'o ("$ u"(e$ '"#9*:n %e'*enen "+u" )o% ee'o o$#-'*o, &e e$'" o%#", '"#9*:n "u#en'"n e(

)e%*$'"('*$#o. L" (ehe &e #"+ne$*o e$ un ("6"n'e $"(*no.

Lu9%*"n'e$ &en'%o &e e$'e +%u)o, 'ene#o$ e( "e*'e #*ne%"(, ue e$ un &e%*!"&o &e( )e'%-(eo h*&%o"%9u%o

$"'u%"&o, ue (o ue h"e, e$ %eu9%*% ("$ )"%e&e$ *n'e$'*n"(e$ (u9%*n&o("$, &e e$'" o%#", *nh*9e (" "9$o%*-n

o(-n*" &e "+u", "*(*'" e( '%n$*'o *n'e$'*n"(. E( )%o9(e#" e$ ue no $e "9$o%9en !*'"#*n"$ (*)o$o(u9(e$ A, D, E

, )%o!o"n *%%*'"*-n &e (" #uo$" *n'e$'*n"(, "('e%"n (" #uo$" )ue&en )%o&u*% &e+ene%"*one$ neo)($*"$,

((e!"n&o " un" ):%&*&" &e( no%#"( un*on"#*en'o &e( *n'e$'*no.


9/18

Co%);$u(o %en"(, e( u"(, e$' o%#"&o )o% (" )$u(" &e BoJ#"n e( +(o#:%u(o ue e$ un" $e%*e &e ")*("%e$ ue $

enuen'%"n &en'%o &e (" )$u(" &e BoJ#"n.

T;9u(o on'o%ne"&o )%o6*#"(.

A$" &e ?en(e.

T;9u(o on'o%ne"&o &*$'"(.

T;9u(o o(e'o%.

F*n"(#en'e, !"%*o$ ';9u(o$ o(e'o%e$, !"n " o%#"% e( on&u'o o(e'o%.

E( %*@-n '*ene &o$ )"%'e$

Co%'e8".

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)ene'%"%, )ene'%"n #u )ou*'o.

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#:&u(".

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e$'" o%#", (" "%'e%*o(" "e%en'e, *n+%e$" "( +(o#:%u(o, e$ &e*%, (o$ ")*("%e$ +(o#e%u("%e$ *n+%e$"n "( +(o#:%u(o, , e$'o

")*("%e$ +(o#e%u("%e$, '*enen (" "%"'e%$'*" &e ue (" $"n+%e ue en'%" )o% (" "%'e%*o(" "e%en'e, )"$" )o% 'o&o$ (o

")*("%e$ +(o#e%u("%e$, $"(e )o% un" "%'e%*o(" ee%en'e. E$" "%'e%*o(" ee%en'e, &e$)u:$, $e !" " !o(!e% " %"#**"%, !"

o%#"% (o$ ")*("%e$ )e%*'u9u("%e$, %e*:n "((, " '%"!:$ &e e$'o$ ")*("%e$ )e%*'u9u("%e$, !" " $"(*% )o% un" !en". E$o

")*("%e$ )e%*'u9u("%e$, $* (o ue '*enen e$ un" ne%on" o%'*"(, !"n " e$'"% %o&e"n&o " 'o&o$ (o$ ';9u(o$, #*en'%"$ ue $*

ue '*enen e$ un" ne%on" u6'"#e&u("%, !"#o$ " 'ene% un" )"%'e ue !" " e$'"% %o&e"n&o " e$o$ ';9u(o$, !"#o$ " 'en

o'%" )"%'e ue &e$*en&e h"*" "9"=o, =un'o on e( "$" &e ?en(e, e$ &e*%, 'ene#o$ (" %"#" &e$en&en'e, e( "$" &e ?en(e

%"#" "$en&en'e, 'o&o e$'o, on$'*'ue (o ue $e &eno#*n" (" !"$" %e'", " !"#o$ " !e% ue e$ #u *#)o%'"n'e )"%"

#"n'en*#*en'o &e un" #:&u(" h*)e%'-n*". F*+u%" 20>1

Bueno, (" ne%on", o%#" (" o%*n" " )"%'*% &e '%e$ )%oe$o$

F*('%"*-n #o!*#*en'o &e "+u" &e $o(u'o$ &e$&e e( )("$#" " n*!e( &e( +(o#:%u(o h"$'" e( e$)"*o ue e6*$'e en (" )$u

&e BoJ#"n. No $e )e%#*'e e( )"$"=e &e )%o'en"$ n* &e :(u("$ $"n+une"$. E$ &e*%, e$'" *('%"*-n $e &" &e$&e (o

")*("%e$ +(o#e%u("%e$ h"*" e( e$)"*o ue e6*$'e en (" )$u(" &e BoJ#"n. En'one$, (" *('%"*-n, *#)(*" e( )"$"=

&e$&e ("$ :(u("$ en&o'e(*"(e$ &e( ")*("%e$ +(o#e%u("%e$, un" #e#9%"n" 9"$"( '"#9*:n '*ene ue "'%"!e$"% un" ")

e)*'e(*"( &e :(u("$ ue o%#"n (" )"%'e !*$e%"( &e (" )$u(" &e BoJ#"n. n" "%"'e%$'*" ue '*enen e$'o$ ")*("%

+(o#e%u("%e$, e$ ue '*enen un #"o% n;#e%o &e ene$'%"*one$ %e$)e'o " o'%o$ (u+"%e$.

n" !e8 ue $e *('%o, !"#o$ " 'ene% e( u('%"*('%"&o ue !" " *% %eo%%*en&o (o$ ';9u(o$, " (o ("%+o &e (o$ ';9u(o$,

u('%"*('%"&o e$ #o&**"&o )o% )%oe$o$ "9$o%'*9o$ $e%e'o%e$ &*u$*-n $*#)(e, &*u$*-n "*(*'"&", '%"n$)o%'e "'*!

)%*#"%*o '%"n$)o%'e "'*!o $eun&"%*o. L" %e"9$o%*-n *#)(*" e( )"$"=e &e $o(u'o$ &e( (u*&o u'%"*('%"&o ue !" )o% (

';9u(o$ h"*" (" $"n+%e )e%*'u9u("% #*en'%"$ ue (" $e%e*-n, e$ e( )%oe$o *n!e%$o, e$ &e*%, e$ e( )"$"=e &e$&e (" $"n+


10/18

)e%*'u9u("% h"*" e( (u*&o 'u9u("%, )"%" $u )o$'e%*o% $e%e*-n. De e$'e u('%"*('%"&o, (o ue $e e6%e'" no%#"(#en'e o#o

o%*n", e$ un 1K, e$ &e*% ue e( K &e( u('%"*('%"&o e$ "9$o%9*&o. A n*!e( &e( ';9u(o )%o6*#"(, h" un" "('" %e"9$o%*-n

&e ")%o6*#"&"#en'e un 70K, e$ un" %e"9$o%*-n )"%" &*$'*n'o$ *one$ '"(e$ o#o N", , C(, '"#9*:n )"%" e( *-n

9*"%9on"'o, )"%" o$"'o, h" %e"9$o%*-n &e (" +(uo$", &e &*$'*n'o$ "#*no*&o$, e'. En'one$, " n*!e( &e( ';9u(o

)%o6*#"( $e )%o&ue (" %e"9$o%*-n &e un 70K &e( u('%"*('%"&o. Lue+o, en e( "$" &e ?en(e, $e )%o&ue (" onen'%"*-n &e

(" o%*n", #e&*"n'e (" )%e$en*" &e un $*$'e#" #u('*)(*"&o% &e on'%"o%%*en'e, e$ &e*%, h" un $*$'e#" #u('*)(*"&o%

*n'e%"#9*"&o% &e on'%"o%%*en'e #u('*)(*"&o% )o% (o$ ';9u(o$ &e ("$ "$"$ &e ?en(e *n'e%"#9*"&o%, )o% (" !"$" %e'". E$&e*%, !"#o$ " 'ene% &*e%en'e$ )e%#e"9*(*&"&e$ en u"n'o " (" %"#" "$en&en'e " (" %"#" &e$en&en'e &e( "$" &e ?en(e.

En (" %"#" "$en&en'e, (" $"( e$ "9$o%9*&" "'*!"#en'e en (" )"%'e +%ue$" )"$*!"#en'e en (" )"%'e &e(+"&". E$'o$

#e"n*$#o$ &e (" %"#" "$en&en'e, $on (o$ ue !"n " +ene%"% (" h*)e%'on**&"& &e( 'e=*&o *n'e%$'**"(, e$ &e*%, $e +ene%"

un" #:&u(" h*)e%'-n*", " ue e$'" )o%*-n, no e$ )e%#e"9(e "( "+u", )o% (o '"n'o, e( (o%u%o &e $o&*o e$ %e"9$o%9*&o, )e%o

e( "+u" no. E$'" h*)e%'on**&"& &e( (u*&o *n'e%$'**"(, !" " h"e% ue &e$&e (" %"#" &e$en&en'e, (" u"( $* e$ )e%#e"9(e "(

"+u", )"$e "+u", e$ &e*%, $e %e"9$o%9" "+u" h"*" e( (u*&o *n'e%$'**"( &e e$'" o%#", en (" %"#" &e$en&en'e, e( "+u"

$"(e &e (o$ ';9u(o$ e( (u*&o $e h"e #"$ onen'%"&o " #e&*&" ue "("n8" (" u%!"'u%", e$ =u$'"#en'e (o ue (e$ &*=e

"n'e$, e$ &e*%, ue en e( "$" &e ?en(e, $e )%o&ue (" onen'%"*-n &e (" o%*n", =u$'"#en'e )o% e$'e #e"n*$#o ue (e$""9o &e &e$%*9*%. De e$'" o%#", $e %e" un +%"&*en'e o$#-'*o en (" #:&u(", e$ &e*%, !"#o$ " 'ene% *$o'on**&"& o%'*"(

" (" "('u%" &e( ';9u(o on'o%ne"&o )%o6*#"(, h"*" (" #:&u(", $e !" %e"n&o e( +%"&*en'e h"$'" (" 8on" u%!" &e( "$" &e

?en(e, &on&e $e "("n8" un" h*)e%'on**&"& &e 1200>1500 ##o(/L. L" u%e", '"#9*:n on'%*9ue en e$'e +%"&*en'e &e

onen'%"*-n, &e o%#" ue $u onen'%"*-n !" "u#en'"n&o h"$'" ue "("n8" (o$ ';9u(o$ on'o%ne"&o$ en (" #:&u(",

&on&e &*un&e h"*" e( *n'e%$'**o e$ "'%")"&" en (" #:&u(" *n'e%n". E( un&"#en'o &e e$'e #e"n*$#o, e$ &e*%, &e(

$*$'e#" #u('*)(*"&o% &e on'%"o%%*en'e $e 9"$" en (" e6*$'en*" &e un )eue@o +%"&*en'e o$#-'*o ho%*8on'"( ue $e

#u('*)(*" en $en'*&o !e%'*"(. En 'o&o e$'o, (" !"$" %e'" '"#9*:n on'%*9ue, e$ &e*%, %eue%&en ue (" !"$" %e'"

o%%e$)on&" " ("$ %"#**"*one$ &e (o$ ")*("%e$ )e%*'u9u("%e$ &e (" "%'e%*o(" "e%en'e, ue 9"="9"n h"*" (" #:&u(" en

o%#" on=un'" on e( "$" &e ?en(e, en'one$, (" $"( &*un&e )"$*!"#en'e ue%" &e (o$ !"$o$ "$en&en'e$ &en'%o &e (o$

&e$en&en'e$, #*en'%"$ ue e( "+u" &*un&e ue%" &e (o$ !"$o$ &e$en&en'e$ &en'%o &e (o$ !"$o$ "$en&en'e$. E$'e

#o!*#*en'o &e $"( "+u", $* ue%" #u %)*&o, #e &*(u*%" no #e )e%#*'*%" (o+%"% (" h*)e%'on**&"&, )e%o o#o e(

)%oe$o e$ (en'o, o )ue&o on$e%!"% (" h*)e%'on**&"& &e( (u*&o #e&u("%, " $u !e8, +%"*"$ " (" e6*$'en*" &e e$'o$

';9u(o$ en (o$ ue e( (u*&o *%u(" en $en'*&o o)ue$'o, $e )ue&e #"n'ene% (" h*)e%'on**&"& &e( (u*&o #e&u("%.

En'one$, e( #e"n*$#o &e '%"n$)o%'e "'*!o &e N", en &on&e $e %e"9$o%9e e( N" ue e$' +ene%"n&o e$" h*)e%'on**&"&

&e( (u*&o #e&u("%, !" " $e% (" ue%8" *#)u($o%" )"%" ue h"" un" %e"9$o%*-n &e "+u" en e( ';9u(o o(e'o%, )o%

*n(uen*" &e (" ho%#on" "n'*&*u%:'*". To&o e$'o (o )o&e#o$ !e% en e( $*+u*en'e e$ue#" F*+u%" 20>H

Bueno, "ho%" !"#o$ " h"9("% &e (o$ &*u%:'*o$.

Lo$ &*u%:'*o$, "u#en'"n (" e6%e*-n &e N" &e "+u" &e( o%+"n*$#o #e&*"n'e $u$ ee'o$ $o9%e e( %*@-n. u "*-n

)%*n*)"( e$ &*$#*nu*% (" %e"9$o%*-n &e N" (o%o *('%"&o, (o ue "u#en'" (" ):%&*&" &e "+u" &e9*&o " un" #"o%

e6%e*-n &e $"(, o (o ue e$ (o #*$#o, un" #eno% "9$o%*-n

E( C(N", e$ e( ue )%*n*)"(#en'e e$' %e+u("n&o e( !o(u#en &e (u*&o e6'%"e(u("%, )o% (o ue (o$ &*u%:'*o$ !"n " 'en&e%

" on'%o("%, " &*$#*nu*% e( on'en*&o &e C(N" o%)o%"( 'o'"(. E$ )o% e$'o ue (o$ &*u%:'*o$ $e u$"n )"%"

10


11/18

E&e#" "u#u("*-n &e (u*&o$ en 'e=*&o$ e6'%"e(u("%e$. No%#"(#en'e, e$'o $e )%o&ue )o% %e'en*-n &e N", )

(o u"(, e( )%*n*)"( ee'o &e (o$ %#"o$ &*u%:'*o$ e$ )%o#o!e% (" e6%e*-n &e N", on e( on$euen'e "%%"$'%

&e "+u", &e$"%#"n&o "$ " (" )"'o(o+". E( e&e#" )ue&e $e% "u$"&o )o% *n$u**en*" "%&"" e&e#" )u(#on"%

*%%o$*$ he)'*" "$*'*$, $n&%o#e ne%-'*o, ue#"&u%"$ +%"9e$, '"#9*:n h" e&e#"$ &e "%'e% *&*o)'*o.

T"#9*:n $e (o$ u'*(*8" )"%" e( '%"'"#*en'o &e (" h*)e%'en$*-n "%'e%*"( #uh"$ !ee$, $e u'*(*8" 'e%")*" o#9*n"&" &

un "n'*h*)e%'en$*!o "*n*$'%"&o =un'o on un &*u%:'*o.

e+;n e( #e"n*$#o &e "*-n, (o$ &*u%:'*o$ $e ("$**"n en D*u%:'*o$ ue "';"n &*%e'"#en'e $o9%e ("$ :(u("$ &e ("$ neu%on"$

• Inh*9*&o%e$ &e( $*#)o%'e &e N">>2C( &*u%:'*o$ &e( "$", &*u%:'*o$ &e (#*'e "('o.

• Inh*9*&o%e$ &e( $*#)o%'e N">C( &*u%:'*o$ '*"8*&" )"%e*&o$ " '*"8*&".

• Inh*9*&o%e$ &e (o$ "n"(e$ &e N" &e( e)*'e(*o %en"( &*u%:'*o$ "ho%%"&o%e$ &e .

• An'"+on*$'"$ &e (o$ %ee)'o%e$ " #*ne%"(oo%'*o*&e$ "n'"+on*$'"$ &e (" "(&o$'e%on", &*u%:'*

"ho%%"&o%e$ &e .

D*u%:'*o$ ue "';"n *n&*%e'"#en'e #o&**"n&o e( on'en*&o &e( *('%"&o

• D*u%:'*o$ o$#-'*o$.

• Inh*9*&o%e$ &e (" "nh*&%"$" "%9-n*".

3"#o$ " e#)e8"% on (o$ inhibidores del simporte Na-K-2Cl &*u%:'*o$ &e( "$", &*u%:'*o$ &e (#*'e "('o. e &eno#*n

$*#)o%'e )o%ue e$ un #e"n*$#o &e '%"n$)o%'e $eun&"%*o ue )e%#*'e e( )"$"=e &e !"%*"$ $u$'"n*"$ en un #*$#o $en'*&

" '%"!:$ &e un '%"n$)o%'"&o%. on (o$ #"$ )o'en'e$, ")"e$ &e )%o&u*% un" e6%e*-n &e( 15>25K &e( N" *('%"&

%eue%&en ue o (e$ &*=e ue (o ue no%#"(#en'e $e e6%e'" e$ un 1K. Con$'*'uen un +%u)o &*!e%$o &e %#"o$ &e$&

e( )un'o &e !*$'" u#*o. Den'%o &e e$'e +%u)o enon'%"#o$

Fu%o$e#*&", 9u#e'"&*n", "8o$e#*&", '%*)"#*&" on'*enen un" #*'"& $u("#*&". *&o e'"%n*o &e%*!"&o eno6*":'*o.

To%$e#*&" $u(on*(u%e".

E$'o$ &*u%:'*o$, 9(oue"n e( $*#)o%'e N">>2C( ue e$' u9*"&o en (" #e#9%"n" (u#*n"( &e (" %"#" "$en&en'e +%ue$

&e( "$" &e ?en(e. e une "( $*'*o &e( C(. En'one$, e$'o$ &*u%:'*o$ "';"n " n*!e( &e (" %"#" "$en&en'e &e( "$" &e ?en(

&on&e $e u9*" e( #e"n*$#o #"$ *#)o%'"n'e )"%" &*$#*nu*% (" o$#o("%*&"&. Cu"n&o $e 9(oue" e$'e )%oe$o &

%e"9$o%*-n &e N", no $e )%o&ue e( "u#en'o &e (" o$#o("%*&"& &e (" #:&u(" 1200, en'one$, (" o$#o("%*&"& ue "n'

e%" &e 200, "ho%" $e% #"$ "('" )o% (" *%u("*-n "('" &e N" ue no ue %e"9$o%9*&o. De e$'" o%#", u"n&o ((e+ue#o$

n*!e( &e (o$ ';9u(o$ on'o%ne"&o$, no$ !"#o$ " enon'%"% on ue (" o$#o("%*&"& &e (" #:&u(" e$ #"$ "('", )o% (o '"n'o, )"$"=e &e "+u" "( *n'e%$'**o, !" " $e% #uho #eno%, on (o u"(, (" "n'*&"& &e "+u" ue $e !" " e(*#*n"%, !" " $e% #uh

#"o%. 3"#o$ " 'ene% un" o%*n" #"$ onen'%"&". e &eno#*n" &e 'eho o (#*'e "('o " ue )%o&uen un" &*u%e$

#"%"&" un" +%"n e(*#*n"*-n &e N". A&e#$ &e (" ):%&*&" &e N" &e "+u", $e )%o&ue un" ):%&*&" *#)o%'"n'e &e , C

M+. 3e"#o$ (" $*+u*en'e *#"+en

Bueno, 'ene#o$ :(u("$ ue '*enen en (" #e#9%"n" (u#*n"(, e( $*#)o%'"&o% N">>2C(, en'one$, *n+%e$" N", C(. L

ue%8" *#)u($o%" )"%" ue *n+%e$e N", e$ )%o)o%*on"&" )o% un" 9o#9" AT


12/18

enuen'%" en (" #e#9%"n" 9"$o("'e%"(. E$'" 9o#9", $"" N" #e'e , (" ene%+" e$ )%o)o%*on"&" )o% (" h*&%-(*$*$ &e

AT


13/18

* $e "*n*$'%"n e$'o$ &*u%:'*o$, $e '*ene ue h"e% un on'%o( &e en $"n+%e, $u)(e#en'%$e(o )o% !" o%"( o en&o!eno

o#)(e#en'"%(o$ on (o$ &*u%:'*o$ &e( '*)o "ho%%"&o%e$ &e . L" ):%&*&" &e C" M+, e$' &en'%o &e (

on'%"*n&*"*one$, $o9%e 'o&o en )e%$on"$ ue '*enen &e**en*" en C", )o% (o '"n'o, $* $e "*n*$'%"n en )e%$on"$ o

o$'eo)o%o$*$, h" ue %e"(*8"% #on*'o%eo$ &e (" onen'%"*-n &e C" )"%" '%"'"% &e $u9$"n"% en "$o &e $e% nee$"%*o,

&e**en*" en C" ue $e )%o&ue. F*n"(#en'e, e$'o$ &*u%:'*o$, "u#en'"n en un 15>25K (" e6%e*-n &e N" &e "+u",

ue en (" 8on" &e( ';9u(o on'o%ne"&o )%o6*#"(, $e %e"9$o%9e e( 75K &e (" *('%"*-n +(o#e%u("%, en'one$, e$'"$ &%o+"

'%"9"="n $o9%e e( 15>25K ue ue&- &e( )%oe$o &e %e"9$o%*-n.Aho%" !"#o$ " !e% (o$ inhibidores del simporte Na-Cl &*u%:'*o$ '*"8*&"$ )"%e*&o$ " '*"8*&"$. T*enen un" )o'en

&*u%:'*" #o&e%"&" e(*#*n"*-n #6*#" &e un 5K &e( N" *('%"&o. on $u(on"#*&"$ &e%*!"&"$ &e 9en8o&*"'"8*&"$

%#"o$ $*#*("%e$ &e$&e e( )un'o &e !*$'" "%#"o(-+*o. 3e"#o$ (" $*+u*en'e *+u%"

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e( $*#)o%'"&o% N">C(. Nue!"#en'e, en (" #e#9%"n" 9"$o("'e%"(, 'ene#o$ un" 9o#9" N"> AT


14/18

NC )o&e#o$ 'ene% !:%'*+o, e"(+*" &e9*(*&"&. A n*!e( &e( '%"'o +"$'%o*n'e$'*n"(, )o&e#o$ 'ene% n"u$e"$, !-#*'o$,

"no%e6*", &*"%%e" on$'*)"*-n. T"#9*:n )o&e#o$ 'ene% %e"*one$ &e h*)e%$en$*9*(*&"&. A n*!e( $e6u"(, )ue&en )%o&u*%

&*$#*nu*-n &e (" (9*&o. En u"n'o " (o$ ee'o$ %e("*on"&o$ on "no%#"(*&"&e$ en e( eu*(*9%*o h*&%oe(e'%o('*o, !"#o$

" 'ene% h*)on"'%e#*", h*)o!o(e#*", h*)o'en$*-n, h*)o)o'"$e#*", "("(o$*$ #e'"9-(*", h*)o(o%e#*", h*)o#"+ne$e#*",

h*)e%"(e#*", h*)e%u%*e#*" +o'", " ue %eue%&en ue &*$#*nu" (" e6%e*-n &e *&o ;%*o, h*)e%+(ue#*" "u#en'o

&e( o(e$'e%o(.

E$'n on'%"*n&*"&o$ en )e%$on"$ ue )%e$en'en h*)e%$en$*9*(*&"& " ("$ $u(on"#*&"$, en "$o$ &e h*)on"'%e#*" eh*)o!o(e#*" )%e!*"$.

En u"n'o " ("$ *n'e%"*one$ "%#"o(-+*"$, ("$ '*"8*&"$

D*$#*nuen (o$ ee'o$ &e "n'*o"+u("n'e$, u%*o$;%*o$, $u(on*(u%e"$, *n$u(*n" &e9*&o "( ee'o

h*)e%+(ue#*"n'e ue )%o&uen.

Au#en'en (o$ ee'o$ &e +(u-$*&o$ "%&"o$, "ne$':$*o$, &*u%:'*o$ &e( "$".

Lo$ AINE$, &*$#*nuen e( ee'o &e e$'e '*)o &e &*u%:'*o$, " ue "&e#$ &e( ee'o %en"(, (o$ &*u%:'*o$ '*"8*&"$,

)%o&uen un" !"$o&*("'"*-n " n*!e( !eno$o )o% un #e"n*$#o *n&*%e'o, (o ue *#)(*"%" (" "*-n &e

)%o$'"+("n&*n"$, %eue%&en ue (o$ AINE$, *nh*9en (" $n'e$*$ &e )%o$'"+("n&*n"$. Ano'e%**n" B (o$ +(uoo%'*o*&e$ "u#en'"n e( %*e$+o &e h*)o)o'"$e#*" *n&u*&" )o% ("$ '*"8*&"$.

e (o$ u'*(*8" en e&e#"$ )o% *n$u**en*" "%&"" on+e$'*!" o )o% *n$u**en*" %en"( $n&%o#e ne%-'*o, *n$u**en*"

%en"( %-n*", +(o#e%u(one%*'*$ "+u&". T"#9*:n $e (o$ u$" en e&e#"$ )o% '%"'"#*en'o$ on +(uoo%'*o*&e$. T"#9*:n $e

(o$ u$" )"%" (" h*)e%'en$*-n, " ue )%o&uen h*)o!o(e#*" !eno&*("'"*-n &e9*&o "( ee'o *n&*%e'o #e&*"&o )o%

)%o$'"+("n&*n"$. E$'o$ &*u%:'*o$ )ue&en $e% u$"&o$ )"%" e( '%"'"#*en'o &e o$'eo)o%o$*$.

En'one$, $e u'*(*8"n un&"#en'"(#en'e )"%" e( '%"'"#*en'o &e (" h*)e%'en$*-n "%'e%*"( " ue &*$#*nuen (" )%e$*-n

$"n+une". T"#9*:n $e (o$ u'*(*8" en e&e#"$ #o&e%"&o$.


15/18

E$'o$ %#"o$, o#o e$'n "'u"n&o en (" )o%*-n &*$'"( &e (" ne%on", '*enen un" e*"*" &*u%:'*" (*#*'"&", " u

%eue%&en ue " n*!e( &e( ';9u(o on'o%ne"&o )%o6*#"(, 'en"#o$ un" %e"9$o%*-n &e( 70K ")%o6*#"&"#en'e, " n*!e( &

"$" &e ?en(e, h" un" %e"9$o%*-n &e( 25K ")%o6*#"&"#en'e, )o% (o '"n'o, (" "n'*&"& ue ((e+" "( ';9u(o on'o%ne"&

&*$'"(, e$ #uho #eno%, " ue (" #"o% )"%'e " ue %e"9$o%9*&". De e$'" o%#", (" e*"*" e$ (*#*'"&" %e$)e'o " (o

&*u%:'*o$ ue !*#o$ "n'e%*o%#en'e.


16/18

"u#en'o &e (" 'o6**&"& #e+"(o9("$'o$*$. En e( "$o &e *n$u**en*" %en"(, '"#9*:n e$'"%" "u#en'"&" (" 'o6**&"&, "

ue &*$#*nue (" e(*#*n"*-n &e( #e'"9o(*'o u%*n"%*o.

e (o$ u$" en e&e#"$ e h*)e%'en$*-n %"%" !e8 o#o #ono'e%")*" )o%ue "u$"n n"'%*u%e*$ (e!e, $e (o$ $ue(e u$"%

o#9*n"&o$ on &*u%:'*o$ )e%&e&o%e$ &e , )"%" on$e%!"% e( eu*(*9%*o &e( .

Aho%" !"#o$ " !e% e( o'%o '*)o &e &*u%:'*o$ "ho%%"&o%e$ &e ue $e (o$ &eno#*n" antagonistas de receptores a

mineralocorticoides "n'"+on*$'"$ &e (" "(&o$'e%on".

Den'%o &e e$'e +%u)o, 'ene#o$ " (" e$o)*%ono("'on", (" u"( e$ un "n'"+on*$'" &e (" "(&o$'e%on". L" e*"*" &*u%:'*" !" "&e)en&e% &e (" "n'*&"& &e "(&o$'e%on" ue h" $*&o (*9e%"&". 3e"#o$ e( $*+u*en'e +%*o

L" e$)*%ono("'on", e$ e( ;n*o &*u%:'*o ue no nee$*'" "e&e% " (" (u8 'u9u("% )"%" )o&e% *n&u*% &*u%e$*$, %eue%&en

ue (o$ o'%o$, e%"n $e%e'"&o$ " (" (u8 'u9u("% " $e" )o% #e"n*$#o &e *&o$ o 9"$e$ o%+n*"$. L" "(&o$'e%on", no

nee$*'" "e&e% " (" (u8 'u9u("%, $*no ue (" "(&o$'e%on" (o ue h"e e$ &*un&*% &e$&e (o$ ")*("%e$ )e%*'u9u("%e$ " '%"!:$

&e (" #e#9%"n" !"$o("'e%"( h"*" (" :(u(". A n*!e( *'o)("$#'*o, e6*$'en %ee)'o%e$ )"%" (" "(&o$'e%on", e$ &e*%,

%ee)'o%e$ )"%" #*ne%"(oo%'*o*&e$, en e$'e "$o )"%" (" "(&o$'e%on". Cu"n&o (" "(&o$'e%on" $e une " $u$ %ee)'o%e$

*'o)("$#'*o$, $e )%o&ue un" '%"n$(o"*-n, #*+%"n h"*" e( n;(eo, en e( n;(eo $e une "( DNA e$'*#u(" ("

'%"n$%*)*-n &e un"$ )%o'en"$ ue $on ("$ )%o'en"$ *n&u*&"$ )o% (" "(&o$'e%on". E$'"$ )%o'en"$ *n&u*&"$ )o% (""(&o$'e%on", !"n " "u#en'"% e( n;#e%o &e "n"(e$ &e N" &e %eue%&en ue o (e$ &*=e ue en 'o&" e$'" )"%'e h"9"

"n"(e$ *-n*o$, en'one$, "u#en'"n e( n;#e%o &e e$o$ "n"(e$ )"%" N" &e (" #e#9%"n" (u#*n"(, '"#9*:n "'*!"n

"n"(e$ $*(en'e$, e$ &e*%, ue e$'n en (" #e#9%"n" )e%o ue no e$'n un*on"(e$. A $u !e8, "u#en'"n (" )%o&u*-n

#*'oon&%*"( &e AT< "u#en'"n (" $n'e$*$ &e AT


17/18

L" e$)*%ono("'on" *n'e%"*on" on $"(**("'o$, (o$ u"(e$ &*$#*nuen (" $e%e*-n 'u9u("% &e "n%enon", on (o u"

&*$#*nue (" e*"*" &*u%:'*" &e e$)*%ono("'on".

e (" u'*(*8" "*n*$'%"&" on '*"8*&"$ o &*u%:'*o$ &e( "$" )"%" e( '%"'"#*en'o &e e&e#" e h*)e%'en$*-n. T"#9*:n $e (

u'*(*8" en "$o$ &e h*)e%"(&o$'e%on*$#o )%*#"%*o "&eno#"$ $u)%"%%en"(e$. T"#9*:n $e (" u$" en *%%o$*$ he)'*".

?"$'" ", he#o$ !*$'o (o$ &*u%:'*o$ ue "'u"9"n &*%e'"#en'e $o9%e ("$ :(u("$ &e( %*@-n, )e%o %eue%&en ue 'en"#o

o'%o +%u)o &e %#"o$ ue "'u"9"n *n&*%e'"#en'e, ue #o&**"9"n e( on'en*&o &e( *('%"&o. Den'%o &e e$'e +%u)

'en"#o$ " (o$ &*u%:'*o$ o$#-'*o$ " (o$ *nh*9*&o%e$ &e (" "nh*&%"$" "%9-n*".Aho%" !"#o$ " !e% (o$ inhibidores de la anhidrasa carbónica.

E$'o$ $on (o$ )%*#e%o$ &*u%:'*o$ ue ")"%e*e%on. on &e%*!"&o$ &e ("$ $u(on"#*&"$. Lo$ *nh*9*&o%e$ &*$)on*9(e$ en

"'u"(*&"& $on

Ae'"8o("#*&".

D*(o%en"#*&".

Me'"8o("#*&".

Bueno, " n*!e( e(u("%, e( CO2 )%o!en*en'e &e (" %e+*-n !eno$", en )%e$en*" &e "+u", $e '%"n$o%#" en *&o "%9-n*

%e"*-n ue e$ "'"(*8"&" )o% (" "nh*&%"$" "%9-n*". E( )%o'-n ue (*9e%" e( *&o "%9-n*o, e$ (*9e%"&o " (" (u8 'u9u("&on&e $e o#9*n" on 9*"%9on"'o, e( u"( e$ e(*#*n"&o no%#"(#en'e )o% o%*n".


18/18

"*&o$*$ #e'"9-(*" #o&e%"&". L"$ %e"*one$ '-6*"$ $on )oo %euen'e$ &e)%e$*-n &e (" #:&u(" -$e", (e$*one$ %en"(e$,

%e"*one$ "(:%+*"$, e$'o e$ &e9*&o " (" e$'%u'u%" $u(on"#*&". A &o$*$ "('"$ )%o&uen $o#no(en*" )"%e$'e$*"$.

E$'n on'%"*n&*"&o$ en )"*en'e$ on &e**en*" &e o N".

En (" "'u"(*&"& no $e (o$ u'*(*8" o#o &*u%:'*o$, $*no ue $e (o$ u$" en "$o$ &e +("uo#", e)*(e)$*", e&e#" )o%

*n$u**en*" "%&"" on+e$'*!" o )o% %#"o$, e h*)e%'en$*-n.

E$'o$ *nh*9*&o%e$ '*enen (" &e$!en'"=" &e ue $u$ "*one$ no &u%"n #uho '*e#)o " ue, )o% e=e#)(o, $* 'ene#o$ un

)"*en'e "( u"( (o '%"'"#o$ &u%"n'e un" $e#"n", e( *n&*!*&uo en'%" en un )%oe$o "*&-'*o " ue e$' 9(oue"&o e(#e"n*$#o &e %e")'"*-n &e 9*"%9on"'o, )o% (o '"n'o, e( )? &e (" $"n+%e &e (" %e+*-n, $e h"e #"$ *&o, )o% (o '"n'o,

"u#en'" e( n*!e( &e )%o'one$ $e %e*n'e+%" e( *n'e%"#9*o N">?, "unue 'o&"!" e$' *nh*9*&" (" "nh*&%"$" "%9-n*". E$

)o% e$'o ue no $e (o$ )ue&e u'*(*8"% )o% #uho '*e#)o " ue e( )"*en'e )ue&e en'%"% en un e$'"&o "*&-'*o "&e#$

)o%ue e( &*u%:'*o )*e%&e $u "*-n. En'one$, e$'o$ &*u%:'*o$ $on o9$o(e'o$ " n*!e( 'e%"):u'*o.

F*n"(#en'e, !"#o$ " !e% (o$ diuréticos osmóticos. Reue%&en ue $on &e "*-n *n&*%e'". Lo$ &*u%:'*o$ o$#-'*o$

"';"n "u#en'"n&o (" o$#o("(*&"& &e( )("$#". on "%#"o(-+*"#en'e *ne%'e$, o $e", $on %#"o$ o#o (" +(*e%*n" e(

*$o$o%9*&e ue $e "*n*$'%"n )o% !" o%"(, e( #"n*'o( (" u%e" ue $e "*n*$'%"n )o% !" en&o!eno$". E$'o$ %#"o$ $on

*('%"&o$ )e%o, o no $e %e"9$o%9en o 9*en, (" %e"9$o%*-n e$ #n*#". e e(*#*n"n *n'"'o$ e6e)'o (" +(*e%*n". De e$'"o%#", "( no $e% %e"9$o%9*&o$, ue&"n "h, "u#en'"n&o (" o$#o("(*&"& '"n'o &e( )("$#", o#o "$ '"#9*:n (" &e( (u*&o

'u9u("%. Co#o "u#en'"n (" o$#o("(*&"& &e( (u*&o 'u9u("%, !" " e$'"% &*$#*nu*&" (" %e"9$o%*-n &e "+u". A( e$'"%

&*$#*nu*&" (" %e"9$o%*-n &e "+u", !" " e$'"% "u#en'"&o e( !o(u#en &e (" #*$#", )o% (o ue (" onen'%"*-n &e N" !" "

$e% #eno%, '"#9*:n !"#o$ " 'ene% *e%'" &*$#*nu*-n en (" %e"9$o%*-n &e N". En'one$, "u#en'"n (" )%e$*-n o$#-'*"

&e( (u*&o 'u9u("% %e&uen &e e$" o%#", (" %e"9$o%*-n &e "+u" &*$#*nuen (" onen'%"*-n (u#*n"( &e N", on ("

on$*+u*en'e &*$#*nu*-n &e (" %e"9$o%*-n &e N" en e( ';9u(o on'o%ne"&o )%o6*#"( %"#" &e$en&en'e &e( "$" &e ?en(e.

L" %e"9$o%*-n ue $e !e )%*n*)"(#en'e "e'"&" e$ (" %e"9$o%*-n )"$*!". En u"n'o " (o$ ee'o$ en (" e(*#*n"*-n

u%*n"%*", 'ene#o$ ue *n%e#en'"n (" e6%e*-n &e "+u" N".

En u"n'o " (o$ ee'o$ "&!e%$o$ !"#o$ " 'ene% e6)"n$*-n '%"n$*'o%*" &e( (u*&o e6'%"e(u("%, h*)on"'%e#*" )o% e6'%"*-n

&e "+u" e6'%"e(u("%. T"#9*:n !"#o$ " 'ene% &o(o% &e "9e8", nu$e"$, !-#*'o$. En "$o$ &e *n")"*&"& )"%" o%#"%

o%*n", !"#o$ " 'ene% *n$u**en*" "%&"" /o e&e#" )u(#on"%.

En u"n'o " ("$ ")(*"*one$ 'e%"):u'*"$, no $on ;'*(e$ en $*'u"*one$ "$o*"&"$ " %e'en*-n &e N". e (o$ u$" en "$o &e

"u#en'o &e )%e$*-n *n'%"%"ne"( o *n'%"ou("%.

17-teórico 17 de farmacología general 24

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