Mehtap SAVRAN, Özgür ÖNAL, Nihat ŞENGEZE, Halil AŞÇI, Serpil DEMİRCİ

Alzheimer Hastalarının Tedavisinde Potansiyel İlaç-İlaç Etkileşimleri

Amaç: İleri yaş, artan ko-morbidite prevalansının bir sonucu olarak, Alzheimer hastalığı için ana risk faktörlerinden birisini oluşturur. Alzheimer hastalığın kendisi yanında, bu hastalığa eşlik eden ko-morbiditeler, polifarmasi olarak ifade edilen iki veya daha fazla ilacın eş zamanlı kullanımını ortaya çıkarır. Polifarmasinin istenmeyen sonuçlarından biri, potansiyel ilaç-ilaç etkileşimleridir (pDDI). Bu çalışma Alzheimer hastalarında pDDI’ların değerlendirilmesini amaçlamıştır. Materyal-Metot: 2016-2018 yılları arasında XXX’da bulunan üçüncü basamak bir hastanenin XXX Polikliniğine başvuran hastaların dosyaları retrospektif olarak değerlendirildi. Polifarmasi oranı, pDDI varlığı ve tipi belirlendi. Bulgular: Analiz edilen 115 dosyada yaş ortalaması 75,13+9,38, polifarmasi sıklığı %53,9 olarak hesaplandı. Üç veya daha fazla ko-morbidite varlığı polifarmasi ile ilişkili bulundu. Hastaların %77,4’ünde pDDI saptandı ve en sık görülen tip C tipi etkileşim olarak belirlendi. En fazla sayıda ilaçla etkileşime giren ilaçlar; ketiapin, sitalopram / essitalopram, donepezil, risperidon ve asetilsalisilik asit olarak sıralandı. Sonuç: Alzheimer hastalarında polifarmasi ve bunun bir sonucu olarak pDDI oranları daha yüksek olabilir. Bazı pDDI’lar, istenmeyen etkilerin yanı sıra Alzheimer ilaçlarının terapötik etkilerini de bozabilir. Bu yüzden, Alzheimer hastalarına yeni bir ilaç eklenmesi gerektiğinde pDDI akılda tutulmalıdır.

The Potential Drug-Drug Interactions in Alzheimer Patients’ Treatment

Objective: Advanced age, as a cause of increased prevalenceof co-morbidities, is one of the main risk factors for Alzheimerdisease. Co-morbidities accompanying the Alzheimer as wellas the disease itself elicit polypharmacy which means two ormore drugs used concomitantly. One of the undesirable resultsof polypharmacy is potential drug-drug interactions (pDDI).The study aimed to evaluate the pDDIs in Alzheimer patients.Material-Method: Files of patient who applied to a XXXOutpatient Clinic of a tertiary hospital in XXX between 2016-2018 were evaluated retrospectively. Rate of polypharmacy,presence and type of pDDI were determinated.Results: In the analyses of 115 files, mean age was 75.13+9.38and frequency of polypharmacy was calculated as 53.9%.Presence of 3 or more co-morbidites was associated withpolypharmacy. pDDI was detected in 77.4% of patients andtype C interaction was the most common type. Quetiapine,citalopram/escitalopram, donepezil, risperidone andacetylsalicylic acid were the five drugs that interacted withthe maximum number of other medications.Conclusions: The rate of polypharmacy and pDDI as aconsequence of polypharmacy could be higher in Alzheimerpatients. Some pDDIs could impair the therapeutic effects ofAlzheimer drugs in addition to undesirable effects. So the pDDIshould be kept in mind when a new drug should be added toAlzheimer patient.

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