En busqueda del hipnótico ideal: tratamiento farmacológico del insomnio
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Fecha
2017
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Sociedad Venezolana de Farmacología Clínica y Terapéutica
Resumen
El insomnio es un trastorno del sueño caracterizado por dificultad
para la conciliación o mantenimiento del sueño, por
disminución del tiempo, fragmentación o mala calidad del
sueño, y sensación de cansancio al día siguiente. Se trata de
un problema con gran prevalencia en países industrializados
y representa uno de los motivos de consulta más frecuente
en atención primaria. Su terapéutica incluye medidas farmacológicas
y no farmacológicas. Las drogas hipnóticas incluyen
un amplio rango de moléculas, como benzodiacepinas,
compuestos Z, antidepresivos, antihistamínicos, entre otros,
cada una con propiedades farmacodinámicas y farmacocinéticas
particulares. Basada en evidencia clínica-epidemiológica,
esta revisión discute la eficacia y seguridad de los fármacos
hipnóticos, con el objetivo de establecer el prototipo de
hipnótico ideal para cada tipo de insomnio, considerando las
necesidades o condiciones del paciente.
Insomnia is a sleep disorder characterized by difficulty for the onset or maintenance of sleep, as well as shortening, fragmentation or bad quality of sleep, and feeling unrested the following day. Insomnia boasts a high prevalence in industrialized countries, and represents one of the most frequent chief complaints in primary care. Treatment involves pharmacologic and non-pharmacologic measures. Hypnotic drugs include a wide range of molecules, such as benzodiazepines, z compounds, antidepressants, antihistamines and several others, each with distinct pharmacodynamic and pharmacokinetic properties. Based on clinical and epidemiologic evidence, this review discusses the efficacy and safety of hypnotic drugs, with the objective of establishing the prototype of the ideal hypnotic for each type of insomnia, according to the specific needs of each kind of patient.
Insomnia is a sleep disorder characterized by difficulty for the onset or maintenance of sleep, as well as shortening, fragmentation or bad quality of sleep, and feeling unrested the following day. Insomnia boasts a high prevalence in industrialized countries, and represents one of the most frequent chief complaints in primary care. Treatment involves pharmacologic and non-pharmacologic measures. Hypnotic drugs include a wide range of molecules, such as benzodiazepines, z compounds, antidepressants, antihistamines and several others, each with distinct pharmacodynamic and pharmacokinetic properties. Based on clinical and epidemiologic evidence, this review discusses the efficacy and safety of hypnotic drugs, with the objective of establishing the prototype of the ideal hypnotic for each type of insomnia, according to the specific needs of each kind of patient.
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Palabras clave
Insomnio, Hipnótico ideal, Arquitectura del sueño, Drogas Z, Benzodiacepinas, Insomnia, Ideal hypnotic, Sleep architecture, Z drugs,, Benzodiazepines