#91: Farmacología en neurorrehabilitación del adulto скачать в хорошем качестве

#91: Farmacología en neurorrehabilitación del adulto

En este episodio abordo la farmacología en neurorrehabilitación del adulto desde una perspectiva clínica y realista, pensada especialmente para profesionales no médicos que conviven a diario con informes, pautas y nombres de fármacos sin disponer siempre de un marco claro para interpretarlos. Recorremos los principales medicamentos utilizados en patologías neurológicas frecuentes —ictus, lesión medular, esclerosis múltiple, enfermedad de Parkinson, ELA, distonías y traumatismo craneoencefálico— diferenciando entre tratamientos agudos, terapias modificadoras de la enfermedad y manejo farmacológico de secuelas. A lo largo del episodio explico de forma progresiva los mecanismos de acción, la base neurofisiológica y el estado actual de la evidencia, poniendo especial énfasis en qué fármacos realmente cambian el pronóstico y cuáles cumplen un papel fundamentalmente sintomático. El objetivo no es prescribir, sino entender mejor cómo la farmacología condiciona la recuperación, la participación en terapia y la toma de decisiones en neurorrehabilitación, con una mirada crítica y basada en la evidencia disponible. Referencias del episodio: • Adams, M. M., & Hicks, A. L. (2005). Spasticity after spinal cord injury. Spinal cord (https://pubmed.ncbi.nlm.nih.gov/15838.... • AFFINITY Trial Collaboration (2020). Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial. The Lancet. (https://pubmed.ncbi.nlm.nih.gov/32702.... • Angeli, C. A et al. (2014). Altering spinal cord excitability enables voluntary movements after chronic complete paralysis in humans. Brain : a journal of neurology, 137(Pt 5), 1394–1409. • (https://pubmed.ncbi.nlm.nih.gov/24713.... • Bracken, M. B et al. (1990). A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury. Results of the Second National Acute Spinal Cord Injury Study. The New England journal of medicine (https://pubmed.ncbi.nlm.nih.gov/22785.... • Bracken, M. B et al. (1997). Administration of methylprednisolone for 24 or 48 hours or tirilazad mesylate for 48 hours in the treatment of acute spinal cord injury. Results of the Third National Acute Spinal Cord Injury Randomized Controlled Trial. National Acute Spinal Cord Injury Study. JAMA (https://pubmed.ncbi.nlm.nih.gov/91682.... • Cardenas, D. D et al. (2014). Two phase 3, multicenter, randomized, placebo-controlled clinical trials of fampridine-SR for treatment of spasticity in chronic spinal cord injury. Spinal cord (https://pubmed.ncbi.nlm.nih.gov/24216.... • Chollet, F et al. (2011). Fluoxetine for motor recovery after acute ischaemic stroke (FLAME): a randomised placebo-controlled trial. The Lancet. (https://pubmed.ncbi.nlm.nih.gov/21216.... • EFFECTS Trial Collaboration (2020). Safety and efficacy of fluoxetine on functional recovery after acute stroke (EFFECTS): a randomised, double-blind, placebo-controlled trial. The Lancet. (https://pubmed.ncbi.nlm.nih.gov/32702.... • Fehlings, M. G et al. (2011). A phase I/IIa clinical trial of a recombinant Rho protein antagonist in acute spinal cord injury. Journal of neurotrauma (https://pubmed.ncbi.nlm.nih.gov/21381.... • FOCUS Trial Collaboration (2019). Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial. Lancet (https://pubmed.ncbi.nlm.nih.gov/30528.... • Giacino, J. T et al.(2012). Placebo-controlled trial of amantadine for severe traumatic brain injury. The New England journal of medicine (https://pubmed.ncbi.nlm.nih.gov/22375.... • Goodman, A. D et al. (2009). Sustained-release oral fampridine in multiple sclerosis: a randomised, double-blind, controlled trial. Lancet 6736(09)60442-6 (https://pubmed.ncbi.nlm.nih.gov/19249.... • Goodman, A. D et al., (2010). A phase 3 trial of extended release oral dalfampridine in multiple sclerosis. Annals of neurology (https://pubmed.ncbi.nlm.nih.gov/20976.... • Johnston, S. C et al., (2020). Ticagrelor and Aspirin or Aspirin Alone in Acute Ischemic Stroke or TIA. The New England journal of medicine (https://pubmed.ncbi.nlm.nih.gov/32668.... • Miller, T. M et al., (2022). Trial of Antisense Oligonucleotide Tofersen for SOD1 ALS. The New England journal of medicine (https://pubmed.ncbi.nlm.nih.gov/36129.... • Paganoni, S. et al., (2021). Long-term survival of participants in the CENTAUR trial of sodium phenylbutyrate-taurursodiol in amyotrophic lateral sclerosis. Muscle & nerve. (https://pubmed.ncbi.nlm.nih.gov/33063.... • Shneider, N. A et al., (2025). Antisense oligonucleotide jacifusen for FUS-ALS: an investigator-initiated, multicentre, open-label case series. Lancet (https://pubmed.ncbi.nlm.nih.gov/40414....