Hatice Ferhan KÖMÜRCÜ, Gülhan SARIÇAM, Ömer ANLAR

Eski ve Yeni Kuşak Antiepileptik İlaçların Hemogram Parametrelerine Etkileri Farklı Mı?

Amaç: Antinöbet ilaçların (ANİ) neden oldukları hematolojik yan etkilerle ilişkili farklı sonuçlar vardır. Çalışmamızda ANİ’ların hemogram parametrelerine olan etkilerini araştırdık. Gereç ve Yöntemler: En az altı ay AEİ kullanan 156’sı kadın 293 hastanın hemogram değerleri ANİ kullanmayan 36 sağlıklı kontrol grubunun değerleri ile karşılaştırıldı. Ayrıca ANİ olarak eski kuşak antiepileptik ilaçlardan fenitoin (PHT), karbamazepin (KBZ), valproik asit, daha yeni kuşak antiepileptik ilaçlardan levetirasetam, okskarbazepin, pregabalin (PGB), gabapentin ve ikili ANİ kullanan hastaların hemogram değerleri birbirleri ile karşılaştırıldı. Bulgular: ANİ kullanan hastaların kontrol grubu ile karşılaştırmalarında sadece PHT kullananların beyaz kan hücre değerleri kontrol grubuna göre düşük bulundu (p=0.045). Sağlıklı kontrollerde “red cell distribution width” (RDW) değeri ANİ kullananlara göre daha yüksek bulundu (p<0.001). ANİ kullanan gruplar kendi aralarında karşılaştırıldığında eski kuşak ANİ’lardan olan PHT ve KBZ kullananların PGB kullananlara göre beyaz kan hücre değerlerinde anlamlı düşüklük tespit edildi (sırasıyla p=0.006; P=0.005). Sonuç: ANİ’lar hastalarda hematolojik yan etki olarak özellikle beyaz kan hücre düşüklüğüne neden olabilirler. Daha eski kuşak ANİ’lardan olan PHT ve KBZ’in yeni kuşak ANİ’lardan pregabaline göre beyaz kan hücre değerlerinde azalma yapıcı etkileri daha belirgindir. Hastalar için ilaç seçimi yapılırken ve takipleri süresince ANİ’ların hemogram parametreleri üzerine etkileri göz önüne alınmalıdır.

Anahtar Kelimeler:

Antinöbet ilaçlar, hemogram, beyaz kan hücreleri, RDW

Are the Effects of Old and New-Generation Antiepileptic Drugs on Hemogram Parameters Different?

Aim: There are different comments related to hematological side effects caused by antiseizure drugs (ASDs). In our study, we investigated the effects of ASDs on hemogram parameters. Materials and Methods: Hemogram values of 293 patients including 156 women, who used ASDs for at least six months, were compared with the values of 36 healthy control participants group who did not. In addition, the hemogram values of the patients using old-generation antiepileptic drugs such as phenytoin (PHT), carbamazepine (CBZ), valproic acid were compared with those using new-generation antiepileptic drugs as levetiracetam, oxcarbazepine, pregabalin (PGB), gabapentin and two ASDs in combination. Results: Comparison of the patients using ASDs with the control group revealed that white blood cell (WBC) values of only PHT users were lower than the control group (p=0.045). Red cell distribution width (RDW) values were found to be higher in healthy controls than those using AEDs (p<0.001). When the groups using ASDs were compared among themselves, it was found that the WBC values of the users of old- generation ASDs as PHT and CBZ were significantly lower than those using PGB (p=0.006; P=0.005, respectively). Conclusion: As hematological side effects, ASDs may decrease WBC counts. The WBC decreasing effects of PHT and CBZ, which are older generation antiepileptics, are more pronounced than pregabalin, which is a new- generation antiepileptic drug. The effects of antiepileptic drugs on hemogram parameters of the patients should be taken into consideration while choosing appropriate ASDs and also while following the patient.

Keywords:

Antiseizure drugs, hemogram, white blood cells, RDW,

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