Trisiklik Antidepresan Zehirlenmelerinde Adora Risk Skorlaması

Amaç: Trisiklik antidepresan (TSA) zehirlenmeleri ciddi klinik sonuçlara neden olabilir. TCA zehirlenmesi olan hastaların değerlendirilmesinde “Antidepresan Doz Aşımı Risk Değerlendirmesi” (ADORA) kriterleri kullanılmıştır. Bununla birlikte, bu kriterlerin klinik uygulamadaki yararları hakkındaki veriler, ADORA kriterlerini doğrulamak için yetersizdir. Bu çalışmanın amacı, ADORA kriterlerinin klinik sonuç ile ilişkisini belirlemektir. Gereç ve Yöntem: Çalışmaya yıllık toplam 133 hasta dahil edildi. Hastalar ADORA kriterlerine göre yüksek risk ve düşük risk gruplarına ayrıldı. Bulgular:Ortanca yaş 25 (18-55 yaş aralığında) idi. Hastalar genellikle TCA ajanı olarak amitriptilin kullanmışlardır. En sık görülen semptomlar kuru deri, kusma ve midriyazis idi. Risk sınıflandırmasına göre; Hastaların %59.4'ü yüksek risk grubunda idi. En sık görülen bulgular sağ aks sapması ve aVR de R>S bulgusu idi. ADORA kriterlerine göre 79 hasta (n=%59,4) yüksek risk grubunda idi. Hastaların tümü komplikasyonsuz taburcu edilmişti. ADORA pozitif risk skor sayısı arttıkça yatış süresi, QTc uzunluğu ve nöbet sıklığı artmaktaydı.Sonuç:ADORA kriterleri, TCA zehirlenmesinin değerlendirilmesi ve klinik takibinde faydalıdır.

Anahtar Kelimeler:

trisiklik antidepresanlar, zehirlenme, Antidepresan Aşırı Doz Risk Değerlendirmesi

Adora Risk Identification of Tricyclic Antidepresant

Objective:Tricyclic antidepressant (TCA) poisonings can cause serious clinical outcome. The Antidepressant OverdoseRisk Assessment (ADORA) criteria are used in the assessment of patients with TCA poisoning. However, the data about the benefits of these criteria in the clinical practice are insufficient to validate the ADORA criteria. The aim of this study was to determine the relationship of ADORA criteria with clinical outcome. Materials and Methods:A total of 133 patients who admitted only with TCA poisoning at a university hospital emergency department. The patients were divided into high risk and low risk groups according to ADORA criteria. Results: The mean age was 25 (range 18-55) years. Patients commonly used amitryptiline as TCA agent. Most common symptoms were dry skin, emesis and mydriasis. According to risk classification; 59.4% of the patients were in high risk group. The most common sight finding was the right axis deviation and the AVR was the R> S finding. According to ADORA's opinion, 79 patients (n = 59.4%) were high-risk carriers. The patients were discharged without any complications. As the number of ADORA positive risk scores increased, the length of hospitalization, QTc height and seizure frequency increased. Conclusion: TheADORA criteria is useful in assessment and clinical follow-up of TCA poisoning.

Keywords:

tricyclic antidepressants, poisoning, The Antidepressant Overdose Risk Assessment,

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ISSN: 1309-3878
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez