Oya ÖZATAMER, Ayşegül TARHAN, İlknur ORAL

Anestezide ilaç etkileşimleri

Modern anestezide ilaçların ve tekniklerin birlikte kullanılması giderek artan bir yöntem olarak kabul edilmektedir. İnhalasyon ajanlarına intravenöz opioid ve hipnotiklerin ilavesi hastaya daha konforlu, güvenli, düşük maliyetli anestezi ve erken derlenme sağlamaktadır. Bu uygulamanın kullanılması sırasında ajanların birbiri ile, hasta ile ve hastanın daha önce kullandığı ilaç ve bitkisel ürünler ile olan etkileşiminin bilinmesi önemlidir. Bu nedenle ilaç etkileşim mekanizmalarının ve bunların olası faydalı ve zararlı etkilerinin bilinmesi gerekir. En iyi ajan ve teknik kombinasyonunun hangisi olduğu sorusunun cevabı yoktur. Çünkü etkileşime katkısı olan pek çok etken vardır. Bilinen şudur ki; hastanın aldığı ajan sayısı arttıkça etkileşim kaçınılmaz olur. Bu nedenle ameliyata alınacak hastanın iyi sorgulanarak kullandığı ilaçların kesilmesi, değiştirilmesi ya da devam etmesine karar verilmesi, ameliyat esnasında kullanılan ajanların etkilerinin iyi bilinip olası reaksiyonların zamanında değerlendirilerek gerekli önlemlerin alınması güvenliği arttıracaktır.

Drug interactions in anesthesia

In modern anesthesiology, combined usage of different drugs and techniques has been increasingly accepted. Addition of intravenous opioids and hypnotics to inhalation agents has become a method that gives the patient a more comfortable, secure, economic anesthesia, and faster recovery. During application of this method, it is important to know the interaction of the agents with each-other, with the patient, and with the drugs and the herbal supplements that the patient has been using. For this reason it is necessary to know the drug interaction mechanisms and their possible beneficial and detrimental effects. There is no direct answer to the question what the best agent and technique combination is, because there are many factors that contribute to the interaction. It is known that, as the number of agents increase, the interaction becomes unavoidable. Therefore, with a good history of the surgical patient, decision to stop, change or continue the drugs, with the knowledge of the effects of the agents that are used during the surgery, evaluation of their possible reactions and necessary precautions will increase safety.

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