Cladribina es una desoxiadenosina modificada que evade la acción de la enzima desaminasa de adenosina, lo que resulta en un efecto inmunosupresor por linfopenia y en la consecuente reconstitución de las células del sistema inmune. Entonces, es un fármaco que ayuda al tratamiento de enfermedades autoinmunes como la esclerosis múltiple remitente recurrente (EMRR). Debido a que en la actualidad contamos con una amplia gama de medicamentos para tratar la EMRR, es de gran interés para nosotros identificar el papel que desempeña cladribina entre todas las opciones. El objetivo principal de esta revisión es el de proporcionar información útil, con el apoyo de un caso clínico de estudio, que ayude a los médicos en la toma de decisiones para tratar a los pacientes con EMRR y brindarles las mejores opciones de eficacia y seguridad. Por sus efectos inmunosupresores selectivos, cladribina está indicada para el tratamiento de EMRR de actividad moderada a grave, ya sea en tratamiento de escalada o de inducción. En este artículo se analizarán las características de dicho medicamento para establecer las bases científicas que guíen la toma de decisiones terapéuticas, tomando en cuenta el equilibrio de riesgos y beneficios para el paciente.

Introduction. Scorpion stings occur mainly in spring and summer, with an estimate of approximately 1.2 million cases per year worldwide. About 300,000 poisonings occur within a year, primarily affecting children and adults older than 65 years. In 2019, Guanajuato (Mexico) ranked third in poisoning by scorpion sting with a total of 43,913 cases. The intoxication grades are three where the signs and symptoms are varied. There are two types of antivenom in the Mexican market, and we use Alacramyn® in our case. Case presentation. A 70-year-old female —with grade 1 scorpion sting poisoning, 30 minutes of evolution, with type 2 diabetes and high blood pressure— received two vials of antivenom according to current regulations. She presented transient vagal reaction and subsequent transient pain in the cervical region that radiates to the sacral region. At discharge, there are no data compatible with scorpion sting poisoning. Conclusions. Transient pain in the cervical region to the sacral region may be secondary to an anxiety crisis, hypersensitivity to IgG, or secondary reaction to administration in less time than recommended by the provider. The benefit was greater than the reactions that occurred.

Introduction. Oral ciprofloxacin extended-release formulation decreases the risk of treatment failure and prevents the development of antimicrobial resistance. However, non-equivalent formulations lead to subtherapeutic plasma drug concentrations, increasing the risk of such problems. Objective. To determine the bioequivalence of two oral ciprofloxacin extended-release tablet formulations (1,000 mg) in healthy Mexican volunteers. Material and methods. In this open-label 2 x 2 crossover design study, 26 healthy volunteers were randomly allocated to receive a single dose of the reference drug Cipro XR® (Bayer, Mexico) and the test formulation Ciproflox DM® (Senosiain Laboratories, Mexico). Blood samples were obtained for 24 hours. Ciprofloxacin plasma levels were quantified using a validated liquid chromatography method. Pharmacokinetic parameters were obtained by standard non-compartmental analysis. In order to determine bioequivalence, log-transformed test/reference ratios of C_max, AUC_0-t, and AUC_0-inf were compared by an analysis of variance, followed by the 90% confidence intervals and the Schuirmann bilateral test. Results. The 90% confidence intervals ranged from 85.69 to 114.31% for C_max, 85.16-115.84 % in AUC_0-t,and 85.39-114.61% for AUC_0-inf, all cases were within bioequivalence acceptance criteria (80-125%). Schuirmann test verified the probability that the values were within these criteria (p<0.05). No side-effects were observed with any treatment. Conclusions. The results obtained demonstrate bioequivalence between the analyzed formulations.