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Descripción (Español)


El Alprazolam es un fármaco que pertenece a la clasificación farmacológica de las benzodiazepinas y por su acción se clasifica como ansiolítico.

Historia
El Alprazolam fue sintetizado por el investigador Jackson  B. Hester de los antiguos Laboratorios Upjohn, que hoy son parte del conglomerado Pfizer. Posee la patente número 3,987,052, y puesto a la venta desde 1981. Al principio, el fármaco fue indicado para casos de crísis de angustia (ataques de pánico), pero posteriormente, el psiquiatra David Sheehan sugirió que el medicamento se dirigiera a los desordenes de ansiedad.

Farmacología
El Alprazolam es una triazolobenzodiazepina, es decir, posee un anillo triazolo unido a su estructura. Está indicado en el tratamiento de la ansiedad (neurosis de ansiedad), ansiedad con síntomas de depresión y crísis de angustia.

Farmacocinética y mecanismo de acción
El Alprazolam deprime el sistema nervioso central El Alprazolam se une al receptor GABAA que es responsable de mediar los efectos de ácido gamma-aminobutírico (GABA) en el cerebro sobre el sitema activador reticular ascendente bloqueando la excitación tanto cortical como límbica. El receptor GABAA está constituído por hasta 5 subunidades de 19 posibles y los receptores GABAA con diferentes combinaciones de subunidades poseen diferentes propiedades, así mismo diferentes ubicaciones en el cerebro, y lo más importante, diferentes actividades en lo que respecta a las acciones de las benzodiazepinas.

Clínicamente, todas las benzodiazepinas causan una depresión del sistema nervioso central dependiendo de la dosis variando desde las mínimas alteraciones hasta la hipnosis.

— Absorción: Tras una dosis, el fármaco es rápidamente absorbido alcanzando picos en suero entre 1 y 2 horas después de la administración oral.
— Distribución: Se distribuye ampliamente en todo el cuerpo. Cerca del 80-90% de la dosis se une a proteínas plasmáticas.
— Metabolismo: El Alprazolam se metaboliza en el hígado para ser transformado en alfa-hidroxiAlprazolam y en otros metabolitos inactivos.
— Eliminación: La vida media de eliminación del Alprazolam es de 12 a 15 horas. El tracto urinario es la principal vía de eliminación y se excreta en forma de alfa-hidroxiAlprazolam y metabolitos sin actividad farmacológica.

Indicaciones
El Alprazolam está indicado en los estados de ansiedad simple, que pueden incluir ansiedad, tensión, temores, aprensión, dificultad de concentración, insomnio y/o hiperactividad autonómica, irritabilidad. Y también puede prescribirse en ansiedad asociada a otros padecimientos, como la fase crónica de la abstinencia alcohólica, en padecimientos orgánicos o funcionales, como en procesos gastrointestinales, cardiovasculares y algunos padecimientos dermatológicos.

Así mismo, el médico tratante puede elegir el fármaco en casos agudos de crisis de angustia (ataques de pánico) en agorafobia o en ataques de pánico sin fobia asociada.

Precauciones y advertencias
Las personas con hipersensibilidad a las benzodiazepinas deben evitar tomar este medicamento. Tampoco lo deben tomar personas con glaucoma de ángulo estrecho o miastenia gravis. Al igual que con las demás benzodiazepinas, el Alprazolam se excreta por la leche materna y atraviesa la barrera placentaria. Tiene potencial teratógeno. Como regla general se recomienda a las mujeres no amamantar mientras se está bajo tratamiento con Alprazolam. Las personas menores de 18 años deben evitar la toma. El uso continuado produce dependencia física y psíquica, debiendo luego acogerse a un programa de reducción controlada por especialistas por el riesgo de ataques convulsivos si se suspende bruscamente el tratamiento.

Interacciones
El Alprazolam potencia los efectos depresores de las fenotiacinas, barbitúrico, alcohol, psicotrópicos, anticonvulsivantes, antihistamínicos y otros fármacos que por su naturaleza misma producen depresión del sistema nervioso central.
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