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Akılcı İlaç Kullanımı ve Parkinson Hastalığı

Year 2016, Volume: 6 Issue: 2, 104 - 109, 19.10.2016
https://doi.org/10.16899/ctd.01262

Abstract

Amaç: Parkinson hastalığı (PH) bazal gangliyonda GABA aktivitesinde artış ve nigrostriatumda dopamin kaybı ile ilişkili görülen rijidite, istirahat tremoru, sabit yüz ifadesi ve giderek hızlanan yürüyüş şekli ile karakterize nörodejeneratif hastalıktır.(1) Günümüzde uygulanan tedaviler daha çok hastalık belirtilerini kontrol altına almaya yöneliktir. Hastalığın tedavisi  başta hasta uyuncu olmak üzere, ilaç etkileşimleri,  farmakovijilans,  farmakoekonomi gibi farmakolojinin tüm alt çalışma alanları boyutu ile ele alındığında  doğru olarak yapılabilir. Çalışmamızda parkinson tanısı alan ve tedavisi başlanan hastalarımızda hastalığın görüldüğü yaş, eşlik eden hastalıkları, ilaç kullanımı ve yan etkileri incelemeyi ve literatürde hastalıkla ilişkilendirilen  Vit B12, TSH, Trigliserid, Folik asid düzeylerini araştırmayı amaçladık. 
Yöntem: Çalışma, Kütahya ili Dumlupınar Üniversitesi Tıp Fakültesi Evliya Çelebi Eğitim ve Araştırma Hastanesi’ne 2006 ve 2013 tarihleri arasında başvuruda bulunan Parkinson hastalığı tanısı alan 111 hastada yapıldı. Hastalara ait yaş, cinsiyet, kullanılan ilaç, eşlik eden hastalıklar, eşlik eden hastalığına ilişkin olarak gördüğü tedaviler, yan etkiler, dosyalarında veri olarak bulunan 44 hastaya ilişkin B12 vitamin değerleri, Trigliserid düzeyleri, TSH ve Folik asid düzeyleri, takip dosyalarından retrospektif olarak incelendi. 
Bulgular: Çalışmaya Parkinson tanısı almış 111 kişi dahil edilmiştir ve bunların 47`si (%42,3) kadın 64`ü (%57,7) erkek hastadan oluşmaktaydı. Hastalığın sık görüldüğü yaş aralığı (65-74), yaş ortalaması 64 (25-86) idi. 111 olgunun 107’e (%96,3) antiparkinson tedavi başlanmıştı. Parkinson hastalığına eşlik eden hastalıklar incelendiğinde ise 111 hastanın 78`inde (%70,2) herhangi herhangi bir eşlik eden hastalık görülmemiştir. Eşlik eden hastalık görülen 8 kişide (%24,4) depresyon meydana gelmiş, 13 kişide (%39,4) hipotiroidi, 7 kişide (%21,2) DM, 2 kişide (%6,2) hiperlipidemi gözlenmiştir. Hastaların 40`ı (% 36) ek ilaç kullanmamıştır, ancak diğer 71 kişi de (% 63) ek ilaç kullanımı görülmüştür. Çalışmamızda Laboratuvar verilerine ulaşabildiğimiz 44 hastaya ait veriler yorumlandığında, ortalama olarak B12 değeri 412.53, TSH değeri 1.48, Folat değeri 9.35, TG değeri 131.56`dır. B12 değeri 44 hastanın 32’de (%73), TSH değeri 44 hastanın 24’de (% 55), Folat değeri 44 hastanın 30’da (% 68) düşük, TG değeri 44 hastanın 23’de (% 47) düşük olarak bulunmuştur. 
Tartışma ve Sonuç: Parkinson hastalığı tedavisinde Akılcı İlaç kullanımı son derece önemlidir. Tedavi başarısında en önemli faktörlerden birisi tedaviye uyumdur. Hastalık ile ilgili literatürlerde yer alan folat, B12, TSH, Trigliserid düzeylerinin tanı konmuş tedavi gören hastalarda dikkatli bir şekilde takibinin yapılıp gerekli önlemin alınması tedavi başarısında sinerjistik katkı sağlayacaktır. 
 

References

  • Güleç F, Çolakoğlu Z, Eker Ç ve ark. (2008) Psikotik manik atak ile başvuran bir dopamin disregülasyon sendromu olgusu. J Neurol Sci (Turk), 25:176-181.
  • Jankovic J. Parkinson’s disease: clinical features and di- agnosis. J Neurol Neurosurg Psychiatry 2008;79:368- 376.
  • Rajput AH and Birdi S. Epidemiology of Parkinson’s Disease Parkinsonism & Related Disorders, 1997;3: 175-186.
  • Rajput AH, Rajput A, Rajput M. Epidemiology of Par- kinsonism. In: Pahwa R, Lyons KE, Koller WC (eds) Handbook of Parkinson’s Disease, 3rd edition, Marcel Dekker Inc., New York, 2003: 17-42.
  • Tanner CM, Hubble JP, Chan P. Epidemiology and ge- netics of Parkınson’s disease. In: Watts RL, Koller WC (eds) Movement Disorders: Neurologic Principles and Practice, McGraw-Hill, New York, 1997: 137-152.
  • Torun Ş, Uysal M, Gücüyener D, Özdemir G. Parkin- son’s disease in Eskişehir, Turkey. Eur J, 1995; 2 (suppl. 1): 44-45.
  • Waters CH. Parkinson Hastalığının Tanı ve Tedavisi. Çev: Büyükkal B, Turgut Yayıncılık ve Tic. A.Ş.İstanbul, 2000.
  • Lauterbach EC (2004) The neuropsychiatry of parkin- son’s disease and related disorders. Psychiatr Clin N Am, 27:801-825.
  • Nuti A, Ceravolo R, Piccinni A, Dell’ Angelo G, Bellini G, Combaccini G, et al. Psychiatric comorbidity in a pop- ulation of Parkinson’s disease patients. Eur J Neurol 2004;11(5):315–20.
  • Fleminger S. Left-sided Parkinson’s disease is associat- ed with greater anxiety and depression. Psychol Med 1991;21(3):629–38.
  • Çakmur R, Dönmez Çolakoğlu B, ve ark. Parkinson hastalığının tedavisinde kanıta dayalı yaklaşım. Tür- kiye Klinikleri Nöroloji2008; 4: 51-59.
  • Nilsson, K, Warkentin, S, Hultberg, B, Faldt, R, Gustaf- son, L. 2000a. Treatment of cobalamin deficiency in dementia, evaluated clinically and with cerebral blood flow measurements. Aging Clin. Exp. Res. (Milano) 12, 199–207.
  • Cunha, U.G., Rocha, F.L., Peixoto, J.M., Motta, M.F., Barbosa, M.T., 1995. Vitamin B12 deficiency and de- mentia. Int. Psychogeriatr. 7, 85–88.
  • Meins, W Muller-Thomsen, T, Meier-Baumgartner H.P. 2000. Subnormal serum vitamin B12 and behavioral and psychological symptoms in Alzheimer’s disease. Int. J. Geriatr. Psychiatry 15, 415–418.
  • Rogers JD, Sanchez-Saffon A, Frol AB, Diaz-Arrastia R. Elevated homocysteine levels in patients treated with levodopa: association with vascular disease. Arch Neurol 2003;60(1):59–64.
  • N.I. Triantafyllou et al. / Folate and vitamin B12 lev- els in levodopa-treated Parkinson’s disease patients: Their relationship to clinical manifestations, mood and cognition Parkinsonism and Related Disorders 14 (2008) 321–325
  • Duan W, Ladenheim B, Cutler RG, Kruman II, Cadet JL, Mattson MP. Dietary folate deficiency and elevated homocysteine levels endanger dopaminergic neu- rons in models of Parkinson’s disease. J Neurochem 2002;80(1):101–10.
  • Toth C, Breithaupt K, Ge S, Duan Y, Terris JM, Thies- sen A, et al. Levodopa, methylmalonic acid, and neu- ropathy in idiopathic Parkinson disease. Ann Neurol 2010;68:28-36.
  • Xiaoyan Guo, Wei Song, Ke Chen, XuePing Chen, Zhen- zhen Zheng, Bei Cao, Rui Huang, Bi Zhao, Ying Wu, and Hui-Fang Shang The serum lipid profile of Parkinson’s disease patients: a study from China Int J Neurosci. 2014 Nov 6. [Epub ahead of print]See comment in PubMed Commons below
  • Scigliano G, Musicco M, Soliveri P, Piccolo I, Ronchetti G et al. (2006) Reduced risk factors for vascular dis- orders in Parkinson disease patients: A case-control study. Stroke 37: 1184-1188.
  • Howard Tandeter , Amalia Levy , Guy Gutman , Pesach Shvartzman Subclinical thyroid disease in patients with Parkinson’s diseaseaArchives of Gerontology and Geriatrics 33 (2001) 295–300

Rational Drug Use And Parkinson Disease

Year 2016, Volume: 6 Issue: 2, 104 - 109, 19.10.2016
https://doi.org/10.16899/ctd.01262

Abstract

-Parkinson’s disease (PD) is a neurodegenerative disease characterized by increased activity of GABA in basal ganglia and the loss of dopamine in nigrostriatum, associated with rigidity, resting tremor, gait with accelerating steps, and fixed inexpressive face.(1) Current treatments mostly aim to have the symptoms under control. The treatment of the disease can be done accurately when it is integrated with especially patient compliance and all sub-disciplines of pharmacology like drug interactions, pharmacovigilance and pharmacoeconomy. It is aimed in this study to analyse the age when the disease was determined, comorbid diseases, drug use and adverse effects in patients who were diagnosed Parkinson disease and whose treatment already started and to research the Vitamin B12, TSH, Triglyceride, Folic Acid levels that are related with the disease in the literature. Method- The study was conducted on 111 patients who had applied to Kütahya Dumlupınar University Medical Faculty Evliya Çelebi Education & Research Hospital between 2006 and 2013 and were diagnosed Parkinson disease. The following data of the patients- age, gender, drugs having been used, treatments related with the comorbid diseases, adverse effects, B12 vitamin values in the files of 44 patients, their Triglyceride levels, TSH and Folic acid levels- were reviewed retrospectively from their follow-up files. Findings- The participants of the study were 111 subjects diagnosed Parkinson disease and 47 of them (42,3%) were female while 64 (57,7%) were male. The age range during which the disease was seen frequently was (65-74) and the age average was 64 (25-86). 107 (96,3%) of the 111 subjects were started with antiparkinson treatment. In terms of the comorbid diseases to Parkinson, no comorbid diseases were determined in 78 (70,2%) of the 111patients while depression was seen in 8 ($,4) subjects, hypothyroidis was seen in 13 (39,4%) subjects, DM was seen in 7 (21,2%) subjects, hyperlipidaemia was seen in 2 (6,2%) subjects. 40 (36%) of the patients didn’t use any additional drugs, but additional drug use was determined in 71 (63%) patients. In terms of the data of the 44 patients, whose laboratory data could be obtained, it was found that that on average B12 value was 412.53 and TSH value was1.48 while Folate value was 9.35 and TG value was 131.56. In these 44 patients, B12 value of 32 (73%) patients, TSH value of 24 (55%) patients, Folate value of 30 (68%) patients were low, whereas TG value of 23 (47%) was low. Discussion & Conclusion- Rational drug use is extremely crucial in the treatment of Parkinson disease. One of the most important factors in the treatment success is compliance with the treatment. A careful follow up of folate, B12, TSH, Triglyceride levels related to the disease in the literature in patients diagnosed Parkinson disease and taking the required precautions will provide synergistic contribution to the treatment success-

References

  • Güleç F, Çolakoğlu Z, Eker Ç ve ark. (2008) Psikotik manik atak ile başvuran bir dopamin disregülasyon sendromu olgusu. J Neurol Sci (Turk), 25:176-181.
  • Jankovic J. Parkinson’s disease: clinical features and di- agnosis. J Neurol Neurosurg Psychiatry 2008;79:368- 376.
  • Rajput AH and Birdi S. Epidemiology of Parkinson’s Disease Parkinsonism & Related Disorders, 1997;3: 175-186.
  • Rajput AH, Rajput A, Rajput M. Epidemiology of Par- kinsonism. In: Pahwa R, Lyons KE, Koller WC (eds) Handbook of Parkinson’s Disease, 3rd edition, Marcel Dekker Inc., New York, 2003: 17-42.
  • Tanner CM, Hubble JP, Chan P. Epidemiology and ge- netics of Parkınson’s disease. In: Watts RL, Koller WC (eds) Movement Disorders: Neurologic Principles and Practice, McGraw-Hill, New York, 1997: 137-152.
  • Torun Ş, Uysal M, Gücüyener D, Özdemir G. Parkin- son’s disease in Eskişehir, Turkey. Eur J, 1995; 2 (suppl. 1): 44-45.
  • Waters CH. Parkinson Hastalığının Tanı ve Tedavisi. Çev: Büyükkal B, Turgut Yayıncılık ve Tic. A.Ş.İstanbul, 2000.
  • Lauterbach EC (2004) The neuropsychiatry of parkin- son’s disease and related disorders. Psychiatr Clin N Am, 27:801-825.
  • Nuti A, Ceravolo R, Piccinni A, Dell’ Angelo G, Bellini G, Combaccini G, et al. Psychiatric comorbidity in a pop- ulation of Parkinson’s disease patients. Eur J Neurol 2004;11(5):315–20.
  • Fleminger S. Left-sided Parkinson’s disease is associat- ed with greater anxiety and depression. Psychol Med 1991;21(3):629–38.
  • Çakmur R, Dönmez Çolakoğlu B, ve ark. Parkinson hastalığının tedavisinde kanıta dayalı yaklaşım. Tür- kiye Klinikleri Nöroloji2008; 4: 51-59.
  • Nilsson, K, Warkentin, S, Hultberg, B, Faldt, R, Gustaf- son, L. 2000a. Treatment of cobalamin deficiency in dementia, evaluated clinically and with cerebral blood flow measurements. Aging Clin. Exp. Res. (Milano) 12, 199–207.
  • Cunha, U.G., Rocha, F.L., Peixoto, J.M., Motta, M.F., Barbosa, M.T., 1995. Vitamin B12 deficiency and de- mentia. Int. Psychogeriatr. 7, 85–88.
  • Meins, W Muller-Thomsen, T, Meier-Baumgartner H.P. 2000. Subnormal serum vitamin B12 and behavioral and psychological symptoms in Alzheimer’s disease. Int. J. Geriatr. Psychiatry 15, 415–418.
  • Rogers JD, Sanchez-Saffon A, Frol AB, Diaz-Arrastia R. Elevated homocysteine levels in patients treated with levodopa: association with vascular disease. Arch Neurol 2003;60(1):59–64.
  • N.I. Triantafyllou et al. / Folate and vitamin B12 lev- els in levodopa-treated Parkinson’s disease patients: Their relationship to clinical manifestations, mood and cognition Parkinsonism and Related Disorders 14 (2008) 321–325
  • Duan W, Ladenheim B, Cutler RG, Kruman II, Cadet JL, Mattson MP. Dietary folate deficiency and elevated homocysteine levels endanger dopaminergic neu- rons in models of Parkinson’s disease. J Neurochem 2002;80(1):101–10.
  • Toth C, Breithaupt K, Ge S, Duan Y, Terris JM, Thies- sen A, et al. Levodopa, methylmalonic acid, and neu- ropathy in idiopathic Parkinson disease. Ann Neurol 2010;68:28-36.
  • Xiaoyan Guo, Wei Song, Ke Chen, XuePing Chen, Zhen- zhen Zheng, Bei Cao, Rui Huang, Bi Zhao, Ying Wu, and Hui-Fang Shang The serum lipid profile of Parkinson’s disease patients: a study from China Int J Neurosci. 2014 Nov 6. [Epub ahead of print]See comment in PubMed Commons below
  • Scigliano G, Musicco M, Soliveri P, Piccolo I, Ronchetti G et al. (2006) Reduced risk factors for vascular dis- orders in Parkinson disease patients: A case-control study. Stroke 37: 1184-1188.
  • Howard Tandeter , Amalia Levy , Guy Gutman , Pesach Shvartzman Subclinical thyroid disease in patients with Parkinson’s diseaseaArchives of Gerontology and Geriatrics 33 (2001) 295–300
There are 21 citations in total.

Details

Subjects Health Care Administration
Journal Section Original Research
Authors

Filiz Özyiğit

Sibel Canbaz Kabay

Özlem Arık This is me

Publication Date October 19, 2016
Published in Issue Year 2016 Volume: 6 Issue: 2

Cite

APA Özyiğit, F., Canbaz Kabay, S., & Arık, Ö. (2016). Akılcı İlaç Kullanımı ve Parkinson Hastalığı. Çağdaş Tıp Dergisi, 6(2), 104-109. https://doi.org/10.16899/ctd.01262
AMA Özyiğit F, Canbaz Kabay S, Arık Ö. Akılcı İlaç Kullanımı ve Parkinson Hastalığı. J Contemp Med. April 2016;6(2):104-109. doi:10.16899/ctd.01262
Chicago Özyiğit, Filiz, Sibel Canbaz Kabay, and Özlem Arık. “Akılcı İlaç Kullanımı Ve Parkinson Hastalığı”. Çağdaş Tıp Dergisi 6, no. 2 (April 2016): 104-9. https://doi.org/10.16899/ctd.01262.
EndNote Özyiğit F, Canbaz Kabay S, Arık Ö (April 1, 2016) Akılcı İlaç Kullanımı ve Parkinson Hastalığı. Çağdaş Tıp Dergisi 6 2 104–109.
IEEE F. Özyiğit, S. Canbaz Kabay, and Ö. Arık, “Akılcı İlaç Kullanımı ve Parkinson Hastalığı”, J Contemp Med, vol. 6, no. 2, pp. 104–109, 2016, doi: 10.16899/ctd.01262.
ISNAD Özyiğit, Filiz et al. “Akılcı İlaç Kullanımı Ve Parkinson Hastalığı”. Çağdaş Tıp Dergisi 6/2 (April 2016), 104-109. https://doi.org/10.16899/ctd.01262.
JAMA Özyiğit F, Canbaz Kabay S, Arık Ö. Akılcı İlaç Kullanımı ve Parkinson Hastalığı. J Contemp Med. 2016;6:104–109.
MLA Özyiğit, Filiz et al. “Akılcı İlaç Kullanımı Ve Parkinson Hastalığı”. Çağdaş Tıp Dergisi, vol. 6, no. 2, 2016, pp. 104-9, doi:10.16899/ctd.01262.
Vancouver Özyiğit F, Canbaz Kabay S, Arık Ö. Akılcı İlaç Kullanımı ve Parkinson Hastalığı. J Contemp Med. 2016;6(2):104-9.

Cited By

RSESLIBKNN MAKİNE ÖĞRENMESİ YÖNTEMİ KULLANILARAK PARKİNSON HASTALIĞININ TANISI
Ömer Halisdemir Üniversitesi Mühendislik Bilimleri Dergisi
İlknur BÜTÜNER
https://doi.org/10.28948/ngumuh.655720