Química Farmacéutica
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Browsing Química Farmacéutica by Author "Angulo Mosquera, Verónica"
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Item Neurotoxicidad asociada al uso de los anticonvulsivantes Fenitoína y el Ácido Valproico: una revisión sistemática(Universidad Santiago de Cali, 2025-10-15) Angulo Mosquera, Verónica; Ocampo Chaguendo, Dennis Mauricio (Director)Neurotoxicity induced by valproic acid (VPA) and phenytoin (PHEN) constitutes a significant clinical challenge due to its potentially irreversible impact on neurological function and quality of life. This condition is exacerbated by prolonged treatment or combination therapy, where the risk of reaching supratherapeutic plasma levels increases significantly. A systematic review was conducted following PRISMA guidelines, which included a comprehensive search of electronic databases, analyzing the characteristics of the studies in terms of population, interventions, clinical manifestations, and outcomes, and assessing methodological quality using specific tools for clinical, observational, in-vivo, and in-vitro studies, as well as forensic reports. The studies reviewed reported that neurotoxicity associated with VPA and PHEN is a multifactorial phenomenon, influenced by pharmacokinetic parameters, drug interactions, and individual susceptibility. Among the most common manifestations were ataxia, tremors, nystagmus, cognitive impairment, and encephalopathy, with greater severity in overdose cases. Therapeutic drug monitoring (TDM), individualized dosage adjustment, and early detection through clinical and neurophysiological assessments were highlighted as effective strategies for preventing serious complications. It is concluded that the implementation of integrated monitoring and therapeutic optimization protocols is essential to reduce the risk of neurological sequelae, underscoring the need for future research to establish specific guidelines for the safe management of VPA and PHEN.