Síndrome metabólico iatrogénico derivado del uso de antipsicóticos de segunda generación

• Alfonso Sevillano-Jiménez ^[1] ; Lorena Carrascal-Laso ^[2] ; Ana Belén Romero-Ruíz ^[1]
  1. [1] Hospital Universitario Reina Sofia

     Hospital Universitario Reina Sofia

     Cordoba, España

     
  2. [2] Licenciada en Medicina. Especialista en Psiquiatría. Servicio de Psiquiatría. Hospital Provincial de Zamora. Complejo Asistencial de Zamora. Zamora (España)
• Localización: Metas de enfermería, ISSN 1138-7262, Vol. 25, Nº. 4, 2022, págs. 65-78
• Idioma: español
• DOI: 10.35667/MetasEnf.2022.25.1003081924
• Títulos paralelos:
  • Iatrogenic metabolic syndrome derived of the use of second-generation antipsychotics
• Texto completo no disponible (Saber más ...)
• Resumen
  • español

    Objetivo: aportar evidencias sobre los factores determinantes del síndrome metabólico iatrogénico derivado del uso de antipsicóticos de segunda generación.

    Métodos: se llevó a cabo una revisión narrativa entre enero y febrero de 2020. Para ello se realizaron búsquedas bibliográficas en distintas bases de datos y plataformas: Pubmed, Science Direct, Google Scholar y UpToDate. Se usaron las siguientes palabras clave (MeSH/DeCS): antipsicóticos (antipsychotic agents), antipsicóticos atípicos (atypical antipsychotics), síndrome metabólico (metabolic syndrome), Enfermería (nursing), efectos adversos (side effects), salud mental (mental Health).

    Criterios de inclusión: idioma español e inglés, publicaciones originales y a texto completo de los últimos cinco años, estudio en humanos.

    Resultados: se seleccionaron 32 artículos. La evidencia establece la clozapina, olanzapina y paliperidona como principales antipsicóticos de segunda generación que favorecen el síndrome metabólico. Sería conveniente realizar controles antropométricos y bioquímicos: tensión arterial, peso, perímetro abdominal, índice de masa corporal (IMC), glucosa, HDL y triglicéridos. Se necesita un abordaje terapéutico multimodal para prevenir el síndrome metabólico, mejorar la educación sanitaria en estilos de vida saludable y considerar la polifarmacia homeostática.

    Enfermería asume un rol destacado, mediante la utilización de herramientas de valoración centradas en farmacovigilancia, sexualidad y calidad de vida.

    Conclusiones: se precisa el diseño de políticas sanitarias de calidad acordes con las expectativas y necesidades de la población psiquiátrica, promoviendo estilos de vida saludable y atención psicofarmacológica ante el elevado riesgo cardiovascular.

    La Enfermería de Salud Mental se conforma como piedra angular en la atención, prevención, coordinación y el seguimiento comunitario del síndrome metabólico iatrogénico.

  • English

    Objective: to provide evidence about the factors determining iatrogenic metabolic syndrome derived of the use of second-generation antipsychotics.

    Methods: a narrative review was conducted between January and February 2020. This entailed bibliographic searches in different databases and platforms: Pubmed, Science Direct, Google Scholar and UpToDate. The following key words were used (MeSH/DeCS): antipsychotic agents (antipsicóticos), atypical antipsychotics (antipsicóticos atípicos), metabolic syndrome (síndrome metabólico), Nursing (enfermería), side effects (efectos adversos), mental health (salud mental). Inclusion criteria: Spanish and English languages, original and full-text publications from the last five years, studies in human beings.

    Results: in total, 32 articles were retrieved. Evidence determined that clozapine, olanzapine and paliperidone were the main second-generation antipsychotics contributing to metabolic syndrome. It would be convenient to conduct anthropometric and biochemical monitoring: blood pressure, weight, abdominal perimeter, body mass index (BMI), glucose, HDL and triglycerides. A multimodal treatment approach is needed to prevent metabolic syndrome, as well as an improvement in healthcare education regarding healthy lifestyles, and considering homeostatic polypharmacy. Nursing plays a leading role by using assessment tools focused on pharmacovigilance, sexuality and quality of life.

    Conclusions: healthcare policies must be designed according to the expectations and needs of the psychiatric population, promoting healthy lifestyles and psychopharmacological care due to the high cardiovascular risk. Mental Health Nursing becomes a cornerstone for the care, prevention, coordination and community follow-up of iatrogenic metabolic syndrome.

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