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El secuestro gingival de nifedipina en el crecimiento excesivo gingival inducido por nifedipina
J S Ellis1, R A Seymour, S C Monkman
1Department of Operative Dentistry, Dental School, University of Newcastle upon Tyne, UK.
Lancet (London, England)
|June 6, 1992
Resumen
El uso a largo plazo de nifedipina puede causar crecimiento excesivo de las encías. Las altas concentraciones de nifedipina en el líquido crevicular gingival, pero no en el plasma, sugieren que el secuestro tisular contribuye a este efecto secundario.
Área de la Ciencia:
- Farmacología Farmacología.
- La Medicina Oral es una medicina oral.
- La bioquímica es la bioquímica.
Sus antecedentes:
- El crecimiento excesivo de las encías es un efecto secundario conocido de ciertos medicamentos que afectan a la homeostasis del calcio, incluidos la nifedipina, la ciclosporina y la fenitoína.
- El mecanismo preciso que subyace al crecimiento excesivo gingival inducido por drogas sigue sin estar claro.
Objetivo del estudio:
- Para investigar el perfil farmacocinético de la nifedipina en el plasma y el fluido crevicular gingival (GCF).
- Explorar la relación potencial entre las concentraciones de nifedipina en el GCF y la aparición de crecimiento excesivo de las encías.
Principales métodos:
- Se empleó un ensayo ultrasensible para medir las concentraciones de nifedipina.
- La farmacocinética de la nifedipina se analizó en plasma y GCF de nueve pacientes sometidos a tratamiento a largo plazo con nifedipina para la angina de pecho y la hipertensión.
Principales resultados:
- Siete de los nueve pacientes presentaron concentraciones máximas de nifedipina significativamente más altas en el GCF en comparación con el plasma (15-316 veces mayor).
- Los dos pacientes con niveles indetectables de nifedipina GCF no desarrollaron crecimiento excesivo de las encías.
Conclusiones:
- Los tejidos gingival parecen secuestrar nifedipina, lo que lleva a concentraciones locales sustancialmente elevadas de la droga.
- Estas altas concentraciones de nifedipina dentro de los tejidos de las encías se proponen como un factor clave que predispone al crecimiento excesivo de las encías.
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