Non-Steroid Antiinflamatuar İlaç Aşırı Duyarlılığı Olan Hastaya Akılcı Yaklaşım

ÖzNon-steroidal antiinflamatuar ilaçlar (NSAİİ), çocukluk çağında en sık kullanılan ilaçlar arasındadır ve ilaç ilişkili aşırı duyarlılık reaksiyonları içinde antibiyotiklerden sonra ikinci sırada yer almaktadır. Duyarlı bireylerde zamanlaması, organ tutulumu ve şiddeti değişen aşırı duyarlılık reaksiyonlarına neden olmaktadır. Aşırı duyarlılık reaksiyonları altta yatan mekanizmaya göre alerjik (immünolojik mekanizma ile oluşan) ve alerjik olmayan (non-immünolojik) reaksiyonlar olarak ikiye ayrılır. Tanı genellikle öyküye dayanmaktadır, ancak tek başına öykü ile değerlendirilen hastalar yanlışlıkla ilaç alerjisi tanısı alabilmektedir. Kesin tanı için hastanın ayrıntılı öykü, fizik muayene ve standardize edilmiş tanısal testler ile birlikte değerlendirilmesi önerilmektedir.

Anahtar Kelimeler:

alerji, çocuk, non-steroid antiinflamatuar ilaç

The Rational Approach to a Patient with Hypersensitivity to Non-steroid Anti-inflammatory Drugs

AbstractNonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonlyused drugs in childhood and are the second most common drugs after antibiotics indrug related hypersensitivity reactions. NSAIDs induce hypersensitivity reactionsin sensitive individuals varying in timing, organ involvement and severity. Hypersensitivity reactions to NSAIDs are classified as allergic (caused by immunological mechanism) and non-allergic (non-immunological) reactions according to the underl-ying mechanism. The diagnosis of NSAIDs hypersensitivity is usually based on clinical history, but patients who have been evaluated with history alone may be misdiagnosed as drug allergy. It is recommended to evaluate the patient with detailedhistory, physical examination and standardized diagnostic tests for definitive diagnosis.

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