<\/span><\/h2>\r\n\r\n\r\n\r\nLa ivermectina no \u00e9s una \u00fanica mol\u00e8cula. \u00c9s una mescla de dues mol\u00e8cules molt similars que s’utilitzen sempre juntes: la ivermectina *B1a i la ivermectina B1b, per\u00f2 sempre utilitzem el terme \u201c<\/em>ivermectina\u201d en singular per a referir-nos a aquest principi actiu. \u00c9s una mol\u00e8cula semisint\u00e9tica, ja que partim d’una cosa natural que despr\u00e9s modifiquem:<\/p>\r\n\r\n\r\n\r\nla mol\u00e8cula natural original rep el nom de avermectina, que \u00e9s una mescla de mol\u00e8cules obtinguda a partir del cultiu d’un fong anomenat Streptomyces avermitilis. Obtenir aquesta mescla \u00e9s el primer pas de la s\u00edntesi de ivermectina<\/p>\r\n\r\n\r\n\r\n
La avermectina \u00e9s modificada lleugerament per a obtenir la ivermectina. Aquest canvi es fa per a millorar la seva efic\u00e0cia i el seu perfil de seguretat.<\/p>\r\n\r\n\r\n\r\n
La recerca amb la avermectina i la ivermectina va comen\u00e7ar en la d\u00e8cada de 1970, per\u00f2 no va ser fins a principi dels anys \u201880 que vam poder utilitzar medicaments a base de *ivermectina en humans i en animals.<\/p>\r\n\r\n\r\n\r\n
<\/span>Com funciona?<\/span><\/h2>\r\n\r\n\r\n\r\nLa ivermectina \u00e9s una mol\u00e8cula capa\u00e7 de matar par\u00e0sits de diverses esp\u00e8cies. Actua sobre una estructura cel\u00b7lular pr\u00f2pia dels par\u00e0sits anomenada canals de clorur. Simplificant molt, podem dir que aquests canals estan involucrats en la transmissi\u00f3 de l’impuls nervi\u00f3s dels par\u00e0sits: els canals responen a est\u00edmuls i permeten que l’impuls nervi\u00f3s es propagui i que els m\u00fasculs dels par\u00e0sits es contreguin i relaxin ordenadament. En pres\u00e8ncia de ivermectina aquests canals modifiquen el seu funcionament natural, generant un bloqueig neuromuscular important: els par\u00e0sits no poden moure’s, no poden alimentar-se, no poden respirar\u2026 el bloqueig resulta fatal per a ells.<\/p>\r\n\r\n\r\n\r\n
<\/span>Entre les diferents esp\u00e8cies par\u00e0sites sensibles a aquest principi actiu trobem:<\/span><\/h3>\r\n\r\n\r\n\r\n\r\n- Strongyloides sp<\/em>, par\u00e0sits causants de la estrongiloidiasi. La estrongiloidiasi \u00e9s una parasitosi intestinal que pot estendre’s a altres \u00f2rgans. La sofreixen tant humans com animals, per\u00f2 les causen diferents esp\u00e8cies pertanyents a aquest g\u00e8nere.<\/li>\r\n\r\n\r\n\r\n
- Wuchereria bancrofti<\/em>, par\u00e0sit causant d’una malaltia anomenada filariasis limf\u00e0tica. W. bancrofti viu en el sistema limf\u00e0tic de la persona afectada, causant un augment anormal de la grand\u00e0ria de les extremitats del pacient. Pot portar a la incapacitat permanent.<\/li>\r\n\r\n\r\n\r\n
- Sarcoptes sp<\/em>, par\u00e0sit causant de la sarna en humans i algunes esp\u00e8cies animals. \u00a0<\/li>\r\n\r\n\r\n\r\n
- Demodex sp<\/em>,par\u00e0sits relacionats amb la ros\u00e0cia en humans i amb la sarna demod\u00e9cica en alguns animals.<\/li>\r\n\r\n\r\n\r\n
- Otodectes cynotis<\/em>, par\u00e0sit relacionat amb l’otitis en el gat.<\/li>\r\n\r\n\r\n\r\n
- Gasterophilus spp<\/em>, mosca par\u00e0sita que afecta sobretot els cavalls.\u00a0<\/li>\r\n\r\n\r\n\r\n
- Nematodes <\/em>(\u201ccucs\u201d) i polls que parasiten diferents esp\u00e8cies animals (en humans s’utilitzen altres principis actius enfront de polls i cucs).\u00a0<\/li>\r\n\r\n\r\n\r\n
- Onchocerca volvulus<\/em>, par\u00e0sit relacionat amb problemes visuals i ceguesa propi de zones tropicals.<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n
<\/span>Per qu\u00e8 la ivermectina no ens mata als humans o als mam\u00edfers en els quals s’aplica?<\/span><\/h2>\r\n\r\n\r\n\r\nSenzill: el canal de clor amb el qual interactua no existeix en humans ni en altres mam\u00edfers. Per\u00f2 cura: s\u00ed que hi ha una certa interacci\u00f3 amb altres mol\u00e8cules del nostre organisme, d’aqu\u00ed ve que presenti efectes adversos ben documentats. En el cas dels humans solen ser lleus per\u00f2 per a alguns animals (incloses algunes esp\u00e8cies de gos) pot ser mortal: no intentis donar-li *ivermectina a un animal sense parlar abans amb un veterinari.<\/p>\r\n\r\n\r\n\r\n
La ivermectina per a humans es comercialitza en crema i comprimits. Els animals a m\u00e9s disposen de formes injectables, pasta oral i soluci\u00f3 oral adaptades a les necessitats de les diferents esp\u00e8cies.\u00a0<\/p>\r\n\r\n\r\n\r\n
<\/span>Per a qu\u00e8 s’usa la ivermectina en humans?<\/span><\/h2>\r\n\r\n\r\n\r\nEn humans t\u00e9 les seg\u00fcents indicacions a Espanya:<\/p>\r\n\r\n\r\n\r\n
\r\n- Soolantra\u00ae<\/em>. Aquesta crema a base de ivermectina s’utilitza tant per la seva activitat acaricida enfront de l’\u00e0car involucrat en la ros\u00e0cia (*Demodex *sp) com per la seva activitat antiinflamat\u00f2ria en la pell.<\/li>\r\n\r\n\r\n\r\n
- Ivergalen\u00ae<\/em>, Ivercare\u00ae<\/em>. Aquestes s\u00f3n dues marques equivalents de ivermectina en comprimits per via oral. El seu \u00fas m\u00e9s freq\u00fcent en el nostre mitj\u00e0 \u00e9s per a combatre la sarna *sarc\u00f3ptica per\u00f2 tamb\u00e9 estan autoritzats per a filariasi i estrongiloidiasi.<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n
Tots dos medicaments requereixen recepta m\u00e8dica. Els farmac\u00e8utics podem indicar-te el correcte \u00fas de cada medicament, per\u00f2 el diagn\u00f2stic d’una malaltia, la valoraci\u00f3 de la utilitat per al pacient i la prescripci\u00f3 de ivermectina ha de fer-los un metge.<\/p>\r\n\r\n\r\n\r\n
<\/span>Per qu\u00e8 \u00e9s important?<\/span><\/h2>\r\n\r\n\r\n\r\n\u00c9s una mol\u00e8cula molt important, tan important que:<\/p>\r\n\r\n\r\n\r\n
\r\n- L’Organitzaci\u00f3 Mundial de la Salut ha declarat als medicaments amb ivermectina “medicaments essencials per als sistemes de salut\u201d.<\/li>\r\n\r\n\r\n\r\n
- El descobriment de la avermectina li va valer el Premi Nobel de Medicina de l’any 2015 als seus descobridors.<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n
D’una banda, \u00e9s molt efica\u00e7 contra molts par\u00e0sits diferents. Per un altre, \u00e9s un medicament molt segur i molt econ\u00f2mic. Moltes regions mundials molt pobres, en les quals les parasitosis deixen cegues, incapaciten o limiten seriosament la vida dels pacients, han pogut millorar els seus est\u00e0ndards de vida gr\u00e0cies a ella. I, si seguim amb la bona feina, podr\u00edem arribar a erradicar aquestes parasitosis. Podem dir, sense por d’equivocar-nos, que el seu descobriment va marcar un abans i un despr\u00e9s en el tractament de moltes malalties parasit\u00e0ries.<\/p>\r\n\r\n\r\n\r\n
<\/span>La ivermectina serveix per a tractar la COVID-19?<\/span><\/h2>\r\n\r\n\r\n\r\nNo. A l’inici de la pand\u00e8mia, quan busc\u00e0vem desesperadament alguna cosa que pogu\u00e9s servir contra aquesta nova i mortal malaltia, la *ivermectina es va remenar com un possible tractament. Per qu\u00e8? Perqu\u00e8 la ivermectina va mostrar una certa utilitat enfront del virus de la COVID-19 en assajos pre-cl\u00ednics, \u00e9s a dir, en el laboratori. Per\u00f2 les concentracions a les quals la ivermectina \u00e9s antiviral \u00e9s m\u00e9s de mil vegades superior a la que actua com un antiparasitari; en aquestes quantitats potser no seria un medicament tan segur i, de fet, gent que va prendre *ivermectina pel seu compte durant la pand\u00e8mia va reportar problemes digestius i neurol\u00f2gics. Els assajos cl\u00ednics en humans encara han de demostrar que la ivermectina \u00e9s \u00fatil en casos de COVID-19.<\/p>\r\n\r\n\r\n\r\n
<\/span>Quines precaucions cal tenir amb l’\u00fas de ivermectina?<\/span><\/h2>\r\n\r\n\r\n\r\nLa ivermectina sol ser un medicament ben tolerat. Entre els efectes adversos m\u00e9s freq\u00fcents trobem diarrea, n\u00e0usea, anor\u00e8xia, cefalea i dolor muscular, tots lleus i transitoris. Alguns efectes m\u00e9s severs s\u00f3n la taquic\u00e0rdia o l’an\u00e8mia, per\u00f2 s\u00f3n molt poc freq\u00fcents. I, com sempre que utilitzem un medicament per primera vegada, cal vigilar el desenvolupament d’al\u00b7l\u00e8rgia o hipersensibilitat a la ivermectina\u2026 per sort aix\u00f2 succeeix molt rares vegades.<\/p>\r\n\r\n\r\n\r\n
Si notessis alguna mol\u00e8stia utilitzant la *ivermectina que et va receptar el metge pots comentar-lo en la teva farm\u00e0cia de confian\u00e7a. All\u00ed sabran indicar-te si les teves mol\u00e8sties estan \u201cdins del normal\u201d o si has de contactar al metge.<\/p>\r\n","protected":false},"excerpt":{"rendered":"
La ivermectina \u00e9s un principi actiu que pertany al gran grup dels antiparasitaris. L’Organitzaci\u00f3 Mundial de la Salut considera que els medicaments amb ivermectina s\u00f3n medicaments essencials, \u00e9s a dir, medicaments fonamentals per als sistemes de salut dels pa\u00efsos. Et comptem en aquest article qu\u00e8 \u00e9s la ivermectina, com funciona, per a qu\u00e8 s’utilitza habitualment […]<\/p>\n","protected":false},"author":4,"featured_media":29249,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_mbp_gutenberg_autopost":false,"footnotes":""},"categories":[4,1],"tags":[],"class_list":["post-29251","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-respostes-de-salut","category-salut"],"acf":[],"yoast_head":"\n
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