Adverse Effects of the Antiepileptic Drugs

.: PREFACE
ÖN SÖZ
PREFACE
Prof. Dr. Emel ÖZYÜREKa,Doç. Dr. Arzu YILMAZb
aSağlık Bilimleri Üniversitesi Tıp Fakültesi, Ankara Sağlık Uygulama ve Araştırma Merkezi, Çocuk Hematolojisi ve Onkolojisi Kliniği, Ankara, Türkiye
bAnkara Eğitim ve Araştırma Hastanesi, Çocuk Nörolojisi Kliniği, Ankara, Türkiye
Article Language: TR
Son yirmi yılda birçok yeni antiepileptik ilaç, bileşik tedavide kullanıma girdi. Doğru antiepileptik ilacın seçimi her zaman kolay değildir. Spesifik nöbet tiplerine, epilepsilerdeki etkinliğine ve bireysel hastalarda tolere edilebilirliğine bağlıdır. Antiepileptik ilaçlar kullanılırken, klinisyen bunların spesifik epilepsi formlarını, özellikle idiyopatik jeneralize epilepsiyi ağırlaştırma potansiyelinin farkında olmalıdır. Etki mekanizmaları, farmakokinetikleri, dozajları, endikasyonları, yan etkileri, etkileşimleri dahil olmak üzere bireysel özelliklerini rapor ediyor ve kullanımları için bazı genel pratik tavsiyeler her zaman veriyoruz. Bu makaleler dizisi; antiepileptik ilaçlar hakkında, nörologlar, nöropediatristler, farmakologlar ve aynı zamanda epileptik bir hastayı yönetebilecek tüm kişiler için yararlı olan ayrıntılı bilgiler sunmaktadır. Günlük tıp pratiğimizde bütün yan dal uzmanları antiepileptik ilaç kullanımı nedeniyle yan etki yaşayan bir hasta ile karşılaşmaktadır. Bu yan etkilerin bir kısmı hayatı tehdit edici, bir kısmı orta veya hafif derecededir. Yan etkinin antiepileptik ilaca bağlı olduğunun kanıtlanması, genellikle o bulguya sebep olan diğer hastalıkların dışlanmasını gerektirmektedir. Bazen de bu bulgunun nedenini bulmak için, ek muayene ve tetkikler yetmemektedir. İlgili doktor yan etkinin seyrine göre karar vereceğinden, bir klinik ve laboratuvar takip süreci gerekmektedir. Ağır, hayatı tehdit edici yan etkilerde, genellikle ilgili ilacın kesilerek, değiştirilmesi gerekmektedir. Hafif-orta yan etkilerde ise hastanın takibine, yarar-zarar dengesine göre ilaçla ilgili karar verilebilmektedir.

Çocuk nörologları, bu hasta grubu ile karşılaşan diğer çocuk yandal uzmanları, farmakolog ve genetik doktorlarının gözünden, her çocuk sağlığı ve hastalıkları uzmanının elinin altında olabilecek, gün içinde kliniğinde hemen kullanabileceği, antiepileptik ilaç kullanımı ve istenmeyen etkileri ile ilgili bir kitap hazırladık. Bu kitapta;

*Antiepileptik ilaç kullanırken hastaların nasıl takip edileceğini Dr. Hamit Özyürek,
*Antiepileptik ilaç etkileşmelerini Dr. Atila Karaalp,
*Antiiepileptik ilaçların farmakogenetiğini Dr. Ferda Alpaslan Pınarlı,
*Antiepileptik ilaçların çocuklarda nörokognitif yan etkilerini Dr. Özge Balcı ve Dr. Arzu Yılmaz,
*Antiepileptik ilaçların psikiyatrik yan etkilerini Dr. Rezzan Aydın Görücü ve Dr. Zeynep Göker,
*Antiepileptik ilaçların kardiyak yan etkilerini Dr. Utku Pamuk,
*Antiepileptik ilaçların endokrin yan etkilerini Dr. Eda Mengen ve Dr. Seyit Ahmet Uçaktürk,
*Antiepileptik ilaçların gastrointestinal ve hepatobiliyer sistem yan etkilerini Dr. Semih Sandal ve Dr. Neslihan Gürcan Kaya,
* Antiepileptik ilaçların nefrolojik yan etkilerini Dr. Nesrin Taş ve Dr. Arife Uslu Gökceoğlu,
*Antiepileptik ilaçların romatolojik yan etkilerini Dr. Aslıhan Taşkıran Sağ ve Dr. Erdal Sağ,
*Antiepileptik ilaçların alerjik ve cilt yan etkilerini Dr. İlknur Külhaş Çelik, Dr. Özge Yılmaz Topal ve Dr. Emine Vezir,
*Antiepileptik ilaçların immün sistem fonksiyonu üzerindeki etkilerini Dr. Ayşe Metin, Dr. Ahmet Selmanoğlu ve Dr. Şule Büyük Yaytokgil,
*Antiepileptik ilaçların hematolojik yan etkilerini Dr. Emel Özyürek ve Dr. Tunç Fışgın,
*Antiepileptik ilaç toksisitesini Dr. Sultan Göncü ve Dr. Benan Bayrakcı,
*Antiepileptik ilaç kullanan anne bebeklerinde yan etkilerini

Dr. Aslıhan Köse Çetinkaya ve Dr. Dilek Kahvecioğlu,
sizler için derledi.

Bu kitabın hedefine ulaşmasını ve istenen faydayı sağlamasını diliyoruz. Bu kitapta emeği geçen akademisyenlere, meslektaşlarımıza ve Türkiye Klinikleri çalışanlarına teşekkür ediyoruz.

Prof. Dr. Emel ÖZYÜREK
Editör

Doç. Dr. Arzu YILMAZ
Editör
A series of new antiepileptic compounds have entered into us efor combined treatment over the past two decades. The choice of the right antiepileptic drug is not always easy. It depends on its efficacy in specific seizure types and epilepsies, and on its tolerability in individual patients. When using antiepileptic drugs, the clinician should be aware of their potential for aggravating specific forms of epilepsy, especially idiopathic generalized epilepsy. We report their individual characteristics including mechanisms of action, pharmacokinetics, dosage, indications, side effects, interactions and give some practical advices for their use. This article provides detailed informations about antiepileptic drugs useful for neurologists, neuropediatricians, pharmacologists but also for all persons that can be in charge of an epileptic patient.

In our daily medical practice, pediatric specialists in every branch face with a patient with the side effects of antiepileptic drugs. Some of these side effects are life-threatening, some of them are moderate or mild. Proving the side effect due to the antiepileptic drug requires the exclusion of other disorders causing the same manifestation. To find the cause of the manifestations, sometimes neither additional examinations nor evaluations are enough. Since the physican decides according to the course of the side effect, a clinical and laboratory follow up period becomes necessary. In severe and life-threatening adeverse effects, generally it is necessary to stop the antiepileptic drug and switch to another one. In mild to moderate side effects, the decision about continuation of the drug is based on benefit-harm balance and the follow up of the patient.

We have prepared a book about the use and adverse effects of the antiepileptic drugs through the eye of pediatric neurologists, other pediatric subspecialists, pharmacologist and genetic physicians who meet with these patient group, which is ready under the hands of every pediatrics, can be used promptly in the clinics during the day. In this book;

*How the patients can be followed up while using antiepileptic drug by Hamit Özyürek,MD,
*Antiepileptic drug interactions by Atila Karaalp, MD, PhD,
*Pharmacogenetics of the antiepileptic drugs by Ferda Alpaslan Pınarlı, MD, PhD,
*Neurocognitive adverse effects of the antiepileptic drugs in children by Özge Balcı, MD and Arzu Yılmaz, MD,
*Psychiatric adverse effects of the antiepileptic drugs by Rezzan Aydın Görücü, MD and Zeynep Göker, MD,
*Cardiac adverse effects of the antiepileptic drugs by Utku Pamuk, MD,
*Endocrinological adverse effects of the antiepileptic drugs by Eda Mengen, MD and Seyit Ahmet Uçaktürk, MD,
*Gastrointestinal and hepatic adverse effects of the antiepileptic drugs by Semih Sandal, MD and Neslihan Gürcan Kaya, MD,
* Nephrological adverse effects of the antiepileptic drugs by Nesrin Taş, MD and Arife Uslu Gökceoğlu, MD,
*Rheumatological adverse effects of the antiepileptic drugs by Aslıhan Taşkıran Sağ, MD and Erdal Sağ, MD,
*Allergic and skin adverse effects of the antiepileptic drugs by İlknur Külhaş Çelik, MD; Özge Yılmaz Topal, MD and Emine Vezir, MD,
*The effects of antiepileptic drugs on immune system function by Ayşe Metin, MD, PhD; Ahmet Selmanoğlu, MD and Şule Büyük Yaytokgil, MD,
*Hematological adverse effects of the antiepileptic drugs by Emel Özyürek, MD and Tunç Fışgın, MD,
*Antiepileptic drug toxicity by Sultan Göncü, MD and Benan Bayrakcı,MD
*Adverse effects in infants of mothers taking antiepileptic drugs by Aslıhan Köse Çetinkaya, MD and Dilek Kahvecioğlu, MD,

Aslıhan Köse Çetinkaya, MD and Dilek Kahvecioğlu, MD,
were compiled for you.

We wish achieving the goal of this book; and providing the desired benefit. We would like to thank to all the academicians, colleagues and Türkiye Klinikleri employees who contributed to the book.

Prof. Dr. Emel ÖZYÜREK
Editor

Assoc. Prof. Dr. Arzu YILMAZ
Editör

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