Polifarmacia y fragilidad en al anciano en el contexto hospitalario.
Palabras clave:
Polifarmacia, Fragilidad, Anciano Frágil, Interacciones Farmacológicas, Efectos Adversos, Hospitalización.Resumen
Introducción: La polifarmacia y la fragilidad son condiciones prevalentes y altamente interrelacionadas en los adultos mayores hospitalizados. Su concurrencia crea un escenario de elevada vulnerabilidad para la aparición de interacciones medicamentosas y eventos adversos, lo que comparte la seguridad del paciente y la efectividad del tratamiento.
Objetivo: Analizar la evidencia científica sobre la sinergia negativa entre polifarmacia y fragilidad en el entorno hospitalario, con énfasis en los mecanismos fisiopatológicos, el riesgo de interacciones, y las estrategias para su mitigación.
Methods: A narrative review of the literature was conducted using databases such as PubMed/Medline, SciELO, and the Cochrane Library, using the MeSH terms "Polypharmacy," "Frailty," "Drug Interactions," "Adverse Drug Events," "Aged," and "Hospitalization." Articles in Spanish and English, preferably published within the last 5 years, were selected.
Resultados: La fragilidad, caracterizada por una pérdida de reserva fisiológica, altera la farmacocinética y farmacodinámica de los medicamentos. La polifarmacia (>5 fármacos) es un factor de riesgo independiente para la fragilidad y viceversa. Esta dupla aumenta exponencialmente el riesgo de interacciones fármaco-fármaco y fármaco-enfermedad, causa directa y evitable de caídas, delirium, deterioro funcional y hospitalizaciones prolongadas. La prescripción inapropiada es un hallazgo común en este grupo.
Conclusiones: La intersección entre polifarmacia y fragilidad constituye un "síndrome geriátrico iatrogénico" de alto riesgo en el hospital. Es imperativo implementar estrategias proactivas como la revisión sistemática de la medicación, la aplicación de criterios y el enfoque interdisciplinario con farmacéuticos clínicos y equipos de geriatría para optimizar la prescripción y mejorar los resultados en esta población vulnerable.
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Derechos de autor 2025 Yuniel Abreu Hernández, Daimara Barrera León, Jorge Luis Lorente Montiel
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
