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Asma en pediatría: claves para su diagnóstico y tratamiento según evidencia basada en el paciente - M. Weinberger Neumol Pediatr 2014; 9 (1): 5-7.
Un pequeño subconjunto de pacientes presentaría ries-
go de efectos adversos por LABA. Se ha asociada un leve
aumento de mortalidad en pacientes asmáticos con la admi-
nistración de LABA(21,22). Se informó acerca de 2 pacientes
que presentaban eventos de aparente amenaza a la vida, con
pobre respuesta a broncodilatadores β2 agonistas, quienes
recibían salmeterol; al suspender este medicamento mostra-
ron una respuesta clínica dramática(23). Esto es consistente con
estudios que mostraron que un cierto polimorfismo genético
del receptor de β2 estaba asociado a una regulación negativa
de este receptor durante la administración regular de agentes
β2 agonistas(24-28). La teofilina es un medicamento suplemen-
tario alternativo de eficacia similar a un LABA, a pesar que su
uso es a menos conveniente(29).
CONCLUSIONES
El asma y sus enfermedades relacionadas, la rinitis y la
dermatitis atópica, son problemas médicos que requieren
considerar la información basada en la evidencia, concentrán-
dose en las medidas que tendrían con mayor probabilidad un
mayor impacto. El manejo de estas enfermedades requiere la
adherencia a las indicaciones médicas, educación del paciente,
evaluación regular minuciosa y en especial la comprensión
de su enfermedad por parte del paciente. De esta forma es
posible obtener resultados exitosos.
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