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Farmacoterapia para el síncope mediado neuralmente
D G Benditt1, G J Fahy, K G Lurie
1Cardiac Arrhythmia Center, Department of Medicine, University of Minnesota Medical School, Minneapolis 55455, USA.
Circulation
|September 14, 1999
Resumen
La prevención de síncope recurrente neuralmente mediada, particularmente síncope vasovagal, carece de eficacia probada a largo plazo de los medicamentos. Los tratamientos preferidos actuales incluyen beta-bloqueantes y agentes que aumentan el volumen, con otros bajo investigación.
Área de la Ciencia:
- Cardiología Cardiología.
- Farmacología Farmacología.
- Neurología Neurología.
Sus antecedentes:
- El síncope recurrente neuralmente mediado, especialmente el síncope vasovagal, se maneja con varios agentes farmacológicos.
- Los tratamientos actuales carecen de eficacia definitiva a largo plazo probada por ensayos clínicos aleatorizados.
Objetivo del estudio:
- Revisar las estrategias farmacológicas actuales para prevenir la síncope recurrente mediada neuralmente.
- Para resaltar la necesidad de ensayos clínicos más robustos para establecer bases de tratamiento.
Principales métodos:
- Revisión de la literatura existente sobre intervenciones farmacológicas para la síncope mediada neuralmente.
- Discusión de las clases de fármacos favorecidos y de investigación.
Principales resultados:
- Actualmente se favorecen el bloqueo de los receptores beta-adrenérgicos y los agentes que aumentan el volumen central.
- La disopiramida, los bloqueadores de la recaptación de serotonina y la midodrina muestran potencial, pero requieren más estudios.
Conclusiones:
- Ningún agente farmacológico ha demostrado inequívocamente su eficacia a largo plazo para prevenir el síncope neuralmente mediado recurrente.
- La investigación adicional en fisiopatología y los ensayos controlados con placebo bien diseñados son esenciales para establecer una prevención farmacológica efectiva.
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