Elif BARIŞ, Mukaddes GÜMÜŞTEKİN, M. Aylin ARICI

COVID-19 tedavisinde kullanılan ilaçların güvenliliği

COVID 19 hastalığı etkeni SARS CoV 2, ateş, öksürük, nefes darlığı gibi semptomlara neden olan bir virüstür. Ülkemizi ve tüm dünyayı etkileyen COVID 19 pandemisinde, spesifik olarak COVID 19 enfeksiyonu tedavisi için geliştirilmemiş ve farklı endikasyonlarda kullanılan ilaçların yeniden konumlandırıldığı ve tedavi ile ilgili pek çok klinik araştırmanın yürütüldüğü bilinmektedir. Hastalığın tedavisinde halen klinik araştırmalarla etkililiği ve güvenliliği tanımlanmış bir ilaç bulunmamaktadır. Tedavi yönetimi, elde edilen klinik deneyime göre güncellenmekte ve farklı ülkelerde farklı tedaviler kullanılmaktadır. Şu an için hastalığın tedavisinde kullanılan ilaçlar arasında; antiviraller, antimalaryaller, antibiyotikler, immunomodülatör ilaçlar ve antikoagulan ilaçlar ön plandadır. Tüm bu bahsedilen ilaç gruplarında yer alan ilaçların, COVID 19 hastalığında kullanımında güvenlilikleri ile ilgili olarak da bilgiler gün geçtikçe artmaktadır. Antivirallerden remdesivire bağlı karaciğer fonksiyon testlerinde yükseklik, lopinavir ritonavire bağlı hiperlipidemi, antimalaryallerden hidroksiklorokin ve antibiyotiklerden azitromisine bağlı QT uzaması, immunomodülatörlerden tosilizumaba bağlı nötropeni, antikoagulanlara bağlı ise kanama riski dikkati çekmektedir. Bu derlemede, COVID 19 hastalığı tedavisinde kullanılan ilaçlara bağlı advers reaksiyonlar literatür ışığında sunulmaktadır.

SAFETY OF DRUGS USED IN THE TREATMENT OF COVID-19

The causative agent of COVID 19, SARS CoV 2, is a virus that causes symptoms such as fever, cough, and shortness of breath. Related to the COVID 19 pandemic affecting our country and the whole world, it is known that there are no drugs developed for specific treatment of the infection and drugs used in different indications are repositioned with ongoing clinical trials. Currently, there is not any medication whose efficacy and safety has been defined by clinical trials for treatment of COVID 19. Treatment management is updated according to clinical experience and different treatments strategies are used in different countries. Among the drugs currently used in the treatment of the disease; antivirals, antimalarials, antibiotics, immunomodulatory drugs and anticoagulant drugs are prioritised. Information regarding the safety of these drugs used for COVID 19 treatment is increasing every single day. Antiviral remdesivir induced liver function test abnormalities, hyperlipidemia due to lopinavir ritonovir, QT prolongation due to antimalarial drug hydroxychloroquine and antibiotic azithromycin, neutropenia due to immunomodulators tocilizumab, and bleeding risk due to anticoagulants draw attention. In this review, adverse reactions related to drugs used in the treatment of COVID 19 disease are presented in the light of the literature.

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