Proton Pompa İnhibitörlerinin Kırık Oluşumuna Etkisi ve Bakıma Yansıması

Proton pompa inhibitörleri (PPİ) gastrointestinal sistem hastalıklarında ve nonsteroidal antiinflamatuar ilaçların gastrointestinal sistem üzerindeki yan etkilerini önlemek amacıyla kullanılan ilaçlardır. Ülkemizde yapılan çalışmalar yıllar içinde proton pompa inhibitörlerinin kullanımındaki artışı gözler önüne sermiştir. Tüm ilaçlarda olduğu gibi proton pompa inhibitörlerinin de kullanımıyla bazı istenmeyen etkiler gelişebilmektedir. Artmış kemik kırığı riski proton pompa inhibitörlerinin uzun dönem kullanımları ile ortaya çıkan yan etkiler arasında yer almaktadır. Proton pompa inhibitörlerinin kemik kırığına yol açma nedenleri ile ilgili pek çok teori ileri sürülmektedir. Son yıllarda yapılan meta-analiz ve sistematik derlemelerden ortaya çıkan sonuçlar kırığa zemin hazırladığını destekler nitelikte olup bir yıldan uzun süreli proton pompa inhibitörü kullananlarda kalça kırığı, vertebra kırığı, bilek ve ön kol kırığının proton pompa inhibitörü kullanmayanlara göre birkaç kat daha fazla olduğu yönündedir. Özellikle yaşlı ve kadınlarda kırık riskinin daha fazla olduğu bildirilmektedir. Bu derleme PPİ kullanımının oluşturduğu riskler açısından dikkat çekmesi ve bakımı planlamada yol gösterici olması amacı ile yazılmıştır.

Anahtar Kelimeler:

İlaçla İlişkili Yan Etki, Kırıklar, Proton Pompa İnhibitörleri

The Effect of Proton Pump Inhibitors on Fracture Formation and Reflection on Care

Proton pump inhibitors (PPI) are used in gastrointestinal system diseases and nonsteroidal anti-inflammatory drugs to prevent side effects of gastrointestinal system. Studies in our country have shown the increase in the use of proton pump inhibitors over the years. As it exists in all drugs, the use of proton pump inhibitors may cause some undesirable effects.These side effects can be considered in two groups as short and long term side effects. Increased risk of bone fracture is one of the side effects associated with the long-term use of proton pump inhibitors. A my riad of theories have been proposed regarding the causes of proton pump inhibitors leading to bone fracture. The results obtained from the meta-analysis and systematic reviews conducted in recent years support that they predispose to the fracture and suggest that hip fractures, vertebral fractures, wrist and forearm fractures are several times higher in those who use proton pump inhibitors for more than one year than those who do not use proton pump inhibitors.It is reported that the risk of fracture is higher especially in elderly and women. This review was written to draw attention to the risks posed by the use of PPI and to guide the planning of care.

Keywords:

Drug related side effect, fractures, proton pump inhibitors,

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