Vefik ARICA, Seçil ARICA, Murat TUTANÇ, Sabahat GÜCÜK, Tamer EDİRNE

İNTİHAR AMAÇLI KULLANILAN BAKLOFEN VE ENTOKSİKASYONU: OLGU SUNUMU

Baklofen, merkezi sinir sisteminde bir inhibitör transmitter olan, lipofilik GABA (gamma-aminobutirik asit) analoğudur. Yüksek doz baklofen alımı, beyin ölümünü taklit eden derin koma tablosuna neden olabilir. İlacın plazma düzeylerinin belirlenmesi her zaman mümkün olamayacağı gibi tanı konulmasını da güçleştirebilir. Klinik değerlendirme ve destekleyici tedavilerin önemi büyüktür. Baklofen ile akut zehirlenen hastaların tedavisinde tam donanımlı hastanelerde solunum desteği gerektiğinde verilebilmelidir. Bununla birlikte, olgumuzda da görüldüğü gibi ciddi vakalarda bile prognoz iyi seyreder.

Anahtar Kelimeler:

Baklofen, koma, GABA analogu, entoksikasyon

BACLOFEN USAGE FOR SUICIDE AND øNTOXICATION: CASE REPORT

Baclofen is a lipophilic analogue of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in central nervous system. Baclofen toxicity can be a cause of profound coma with brainstem dysfunction mimicking brain death. Measuring plasma levels is not always possible and may be misleading. It’s important to be careful in clinical evaluation and provide full supportive care. Treatment of patients with acute baclofen intoxication should take place in hospitals appropriately equipped which can provide artificial respiration. However, as demonstrated in our case, the prognosis can be good even in severe cases.

Keywords:

Baclofen, coma, GABA analogue, intoxication,

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Leung NY,WhyteMI,Isbister GK.Baclofen overdose:Defining the spectrum of toxicity.Emergency Medicine Australasia 2006;77-82.
Ostermann ME, Young B, Sibbald WJ, Nicole MW. Coma mimicking brain death following baclofen overdose. Intensive Care Med 2000; 26: 1144-6.
Lee TH, Chen SS, Su SL, Yang SS. Baclofen intoxication: Report of four cases and review of the literature. Clin Neuropharmacol 1992; 15(1): 56-62.
Gerkin R, Curry SC, Vance MV, Sankowski PW, Meinhart RD. First- order elimination kinetics following baclofen overdose. Ann Emerg Med 1986;
: 843-6.
Weissenborn K, Wilkens H, Hausmann HE, Degen PH. Burst suppression EEG with baclofen overdose. Clin Neurol Neurosurg 1991; 93: 77-80.
Sporer KA. Skeletal muscle relaxants. In: Olson KR (Ed). Poisoning and Drug Overdose. Connecticut, Appleton&Lange 1999; 291-3.
Darlene R, Van Dierendonk RN. Baclofen and ethanol ingestion: A case report. J Emergency Medicine 1999; 17(6): 989-93.