\u00a0 \u00a0 \u00a0 1.\u00a0<\/strong>N\u00f6roaminidaz \u0130nhibit\u00f6rleri<\/strong><\/h2>\nVir\u00fcsteki n\u00f6raminidaz enzimini bloke ederek influenza A ve B vir\u00fcslerini yok eder. N\u00f6roaminidaz inhibit\u00f6rleri gurubunda en bilinenlerden olan oseltamivir, zanamivir ve peravimir hakk\u0131nda CDC \u00f6nerileri \u015f\u00f6yle (2);<\/p>\n
\n- Oseltamivir<\/strong><\/u>\u00a0(genelde bilinen jenerik ad\u0131yla Tamiflu\u00ae) oral al\u0131m i\u00e7in uygundur. \u00a0FDA onay\u0131na g\u00f6re erken d\u00f6nemde komplike olmayan \u0130nfluenza tedavisinde \u00f6nerilir. \u00c7ocuklar ve yeti\u015fkinler i\u00e7in FDA onay\u0131 mevcut. E\u011fer \u00e7ocukta kemoterapi alma gibi immun yetmezli\u011fi bozan bir durum varsa 3 ayl\u0131k iken de kullan\u0131m\u0131 \u00f6nerileri literat\u00fcrde mevcuttur (3).<\/li>\n<\/ul>\n
Grip hastal\u0131\u011f\u0131n\u0131n tedavisinde kullan\u0131m\u0131 ise ya\u015flara g\u00f6re de\u011fi\u015fir.\u00a0 T\u00fcrkiye\u2019 de ruhsatland\u0131rma ile prospekt\u00fcs bilgilerine g\u00f6re yeti\u015fkinler ve ergenler taraf\u0131ndan 75 mg kaps\u00fcle veya alternatif olarak bir adet 30 mg kaps\u00fcl ile bir adet 45 mg kaps\u00fcl kullan\u0131labilir. Sabah ak\u015fam g\u00fcnde\u00a0iki kez 75 mg, 5 g\u00fcn s\u00fcre<\/strong>\u00a0ile kullan\u0131l\u0131r. 5 g\u00fcnl\u00fck tedaviyi tamamlamak gerekir.\u00a0 1- 12 ya\u015f aras\u0131nda \u00e7ocuklarda kullan\u0131mda kaps\u00fcl yerine oral s\u00fcspansiyon tozu kullan\u0131labilir. 40 kg\u2019dan fazla ve kaps\u00fcl yutabilen \u00e7ocuklar 5 g\u00fcn boyunca g\u00fcnde iki defa\u00a0Oseltamivir<\/strong>\u00a075 mg kaps\u00fcl kullanabilirler.<\/p>\nProspekt\u00fcs bilgilerine g\u00f6re \u00e7ocuklarda influenza tedavi \u015femas\u0131 a\u015fa\u011f\u0131daki gibidir.<\/p>\n
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Oseltamivir<\/strong>\u00a0ayr\u0131ca grip hastal\u0131\u011f\u0131n\u0131n \u00f6nlenmesinde kullan\u0131labilir.\u00a0 Ergenlerde (13-17 ya\u015f) ve yeti\u015fkinlerde kullan\u0131mda tedavide oldu\u011fu gibi 75 mg kaps\u00fcl veya alternatif olarak 1 adet 30 mg kaps\u00fcl ile 1 adet 45 mg kaps\u00fcl kullan\u0131labilir. Tedavi dozundan farkl\u0131 olarak\u00a0Oseltamivir<\/strong>\u00a0profilaksi amac\u0131yla 10 g\u00fcn boyunca,\u00a0g\u00fcnde bir kez 75 mg<\/strong>\u00a0al\u0131nmal\u0131d\u0131r. Bu dozu sabah kahvalt\u0131s\u0131yla birlikte almak en uygun yoldur.\u00a0 1 ya\u015f \u00fcst\u00fc bebeklerle 2-12 ya\u015f aras\u0131 \u00e7ocuklarda kullan\u0131mda v\u00fccut a\u011f\u0131rl\u0131\u011f\u0131na g\u00f6re \u015femas\u0131 vard\u0131r. Kaps\u00fcl yerine oral s\u00fcspansiyon tozu kullan\u0131labilir.<\/p>\n\u00c7ocuklarda \u0130nfluenza profilaksisinde kullan\u0131m \u015femas\u0131 a\u015fa\u011f\u0131dad\u0131r.<\/p>\n
![\"\"](\"https:\/\/tatd.org.tr\/tatdtoks\/wp-content\/uploads\/sites\/36\/2021\/10\/216-1.png\")
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Oseltamivir\u00a0<\/strong>i\u00e7eren ila\u00e7lar ve e\u015fde\u011ferlerine bu linkten ula\u015fmak i\u00e7in t\u0131klay\u0131n\u0131z<\/a>.<\/p>\nOseltamivir<\/strong>\u00a0En \u00f6nemli yan etkisi, bulant\u0131, kusmad\u0131r (%10-15). Oseltamivir kullan\u0131m\u0131 s\u0131ras\u0131nda Japon adolesanlarda ge\u00e7ici n\u00f6ropsikiyatrik olaylar geli\u015fti\u011fi de bildirilmi\u015ftir. Bu nedenle FDA, oseltamivir kullananlar\u0131n davran\u0131\u015f bozuklu\u011fu a\u00e7\u0131s\u0131ndan yak\u0131n takibini \u00f6nermektedir.<\/p>\n\n- Zanamivir<\/strong>\u00a0( Relenza\u00ae<\/a>)\u00a0 oral inhalasyon i\u00e7in geli\u015ftirilmi\u015f\u00a0 FDA onayl\u0131 erken d\u00f6nemde komplike olmayan influenza tedavisi i\u00e7in \u00f6nerilmi\u015ftir. Tedavi amac\u0131yla 7 ya\u015f ve \u00fczerinde, koruma amac\u0131yla 5 ya\u015f \u00fczerindeki hastalarda kullan\u0131labilir. Altta yatan ast\u0131m veya di\u011fer respiratuar hastal\u0131klar\u0131 olanlarda \u00f6nerilmez. E\u015fde\u011fer olarak bulunan bir ila\u00e7 yoktur;<\/li>\n<\/ul>\n
Allerjik reaksiyonlar, orofaringeal ve fasiyal \u00f6dem bildirilmi\u015f olup bunun d\u0131\u015f\u0131nda en s\u0131k saptanan yan etkiler; diyare, bulant\u0131, sin\u00fczit, nazal bulgu ve semptomlar, bron\u015fit, \u00f6ks\u00fcr\u00fck, ba\u015f a\u011fr\u0131s\u0131, ba\u015f d\u00f6nmesi olarak belirtilmi\u015ftir.<\/p>\n
\n- Peramivir<\/strong>\u00a0(Rapivab\u00ae) intraven\u00f6z uygulama i\u00e7in FDA onayl\u0131 erken d\u00f6nemde influenza tedavisinde 2 ya\u015f ve \u00fczeri hastalarda kullan\u0131lan bir ila\u00e7t\u0131r. T\u00fcrkiye\u2019de \u015fu anda mevcut de\u011fildir.<\/li>\n<\/ul>\n
Gebelikte N\u00f6raminidaz inhibit\u00f6rlerinin kullan\u0131mda dikkatli olunmas\u0131 gerekir. Gebelik kategorisi C olarak bildirilmi\u015ftir.<\/p>\n
\u00a0 \u00a0 \u00a0<\/strong><\/h2>\n\u00a0 \u00a0 \u00a0 2. Cap-dependent Endon\u00fckleaz \u0130nhibit\u00f6rleri<\/strong><\/h2>\nEndon\u00fckleaz inhibit\u00f6rlerinin etkileri n\u00f6raminidaz inhibit\u00f6rlerine g\u00f6re daha farkl\u0131d\u0131r. Endon\u00fckleaz inhibitorleri viral RNA transkripsiyonunu bozar ve viral replikasyonu engelleyerek influenza A and B vir\u00fcslerini \u00f6ld\u00fcr\u00fcr. FDA onayl\u0131 tek cap-dependent endon\u00fckleaz inhibitor\u00fc ila\u00e7 olarak\u00a0Baloxavir marboxil<\/strong>\u00a0(Xofluza\u00ae) mevcut (4). Oral kullan\u0131m i\u00e7in onayl\u0131 bir ila\u00e7t\u0131r.\u00a0 \u0130nfluenzan\u0131n erken d\u00f6neminde 12 ya\u015f \u00fczerinde uygun bulunmu\u015ftur. \u00a0Baloxavir marboxil<\/strong>\u00a0 \u00a0gebeler, lohusalar, komplike hastal\u0131klarda \u00f6nerilmez.<\/p>\n\u00a0 \u00a0 \u00a0 <\/strong><\/h2>\n\u00a0 \u00a0 \u00a0 3. Adamantan grubu<\/strong><\/h2>\nAdamantan grubu influenza A vir\u00fcslerindeki M2 iyon kanallar\u0131n\u0131 hedef olarak al\u0131rlar. Bu y\u00fczden sadece \u0130nfluenza A tipinde etkilidirler. ABD\u2019 de vir\u00fcslerde ilaca kar\u015f\u0131 diren\u00e7 geli\u015fti\u011fi i\u00e7in \u00f6nerilmiyorlar (5). \u00a0\u0130ki jenerik ila\u00e7 mevcut. \u0130lki\u00a0Amantadine<\/strong>\u00a0(jenerik) olup oral kullan\u0131lan FDA onayl\u0131 bir ila\u00e7. Sadece influenza A hastalar\u0131nda ve 1 ya\u015f \u00fczerindekilerde kullan\u0131l\u0131r.\u00a0Rimantadine<\/strong>\u00a0(jenerik veya Flumadine\u00ae) ise di\u011fer grup \u00fcyesidir. FDA onayl\u0131 oral uygulanan ve influenza A\u2019 da etkili antiviral ila\u00e7t\u0131r. Sadece 17 ya\u015f \u00fczerinde kullan\u0131l\u0131r.<\/p>\nBu grubun en \u00f6nemli yan etkileri; geri-d\u00f6n\u00fc\u015f\u00fcml\u00fc n\u00f6rotoksisite (uykusuzluk, anksiyete, ba\u015f d\u00f6nmesi, konsantrasyon bozuklu\u011fu, konf\u00fczyon, konv\u00fclziyon, hal\u00fcsinasyon), epilepsi, renal kreatinin klerensinin azalmas\u0131d\u0131r. Eri\u015fkinde \u00f6nerilen tedavi s\u00fcresi 3-5 g\u00fcn olup tedavi ve profilakside \u00f6nerilen doz: 1x200mg\/ g\u00fcn PO veya 2x100mg\/g\u00fcn PO. \u00a0Tedavi s\u0131ras\u0131nda diren\u00e7 geli\u015fimi en b\u00fcy\u00fck sorundur. Adamantanlarda n\u00f6raminidaz inhibit\u00f6rleri gibi gebelik kategorisi C\u2019de bulunur.<\/p>\n
<\/h2>\nKime Antiviral Tedavi?<\/strong><\/h2>\nAsl\u0131nda \u0130nfluenzay\u0131 \u00f6nlemenin en etkili yolu\u00a0grip a\u015f\u0131s\u0131 yap\u0131lmas\u0131 ve el y\u0131kama\u00a0gibi basit enfeksiyon kontrol \u00f6nlemlerini kullanmakt\u0131r. ABD Hastal\u0131k\u00a0Kontrol ve\u00a0\u00d6nleme Merkezi 6 ayl\u0131ktan b\u00fcy\u00fck t\u00fcm bireylerin hastal\u0131k sezonu \u00f6ncesi yani Ekim ay\u0131 sonuna kadar kontrendikasyonu olmayan ki\u015filerde a\u015f\u0131lanma yap\u0131lmas\u0131n\u0131 \u00f6nermekte.<\/p>\n
Ancak hastal\u0131k geli\u015ftikten sonra ise antiviral tedaviyi kimlere ba\u015flayaca\u011f\u0131m\u0131z\u0131 bilmemiz gerekiyor. Kan\u0131tlanm\u0131\u015f veya \u015f\u00fcpheli grip olan yeti\u015fkinler ve \u00e7ocuklara m\u00fcmk\u00fcn olan en k\u0131sa s\u00fcrede antiviral tedaviye ba\u015flamal\u0131d\u0131r. Ayr\u0131ca a\u015f\u0131 olup olmad\u0131\u011f\u0131na bak\u0131lmaks\u0131z\u0131n influenza tan\u0131s\u0131 kesinle\u015fmi\u015f yat\u0131\u015f verilen hastalarda hastal\u0131k s\u00fcresine bak\u0131lmaks\u0131z\u0131n; ciddi ve ilerleyici hastal\u0131\u011f\u0131 olan yine hastal\u0131k s\u00fcresinden ba\u011f\u0131ms\u0131z olarak ayaktan hastalara; kronik hastal\u0131k \u00f6yk\u00fcs\u00fc olan ve imm\u00fcn yetmezlik tablosu olan hastalara; <2 ya\u015f ve 65 ya\u015f< b\u00fct\u00fcn hastalara; gebeler ve postpartum 2. Haftaya kadar olan hastalara antiviral tedavi ba\u015flanmal\u0131d\u0131r (6).<\/p>\n
<\/h2>\nSon S\u00f6z<\/strong><\/h2>\nAntiviral ila\u00e7 tedavisinin Acil T\u0131p uzmanlar\u0131 taraf\u0131ndan erken ba\u015flanmas\u0131 \u00f6nemlidir \u00e7\u00fcnk\u00fc bu tedavi; semptomlar\u0131n s\u00fcresini ve \u015fiddetini, vir\u00fcs yay\u0131lmas\u0131n\u0131, hospitalizasyon ihtiyac\u0131n\u0131, tedavi maliyetini, \u0130nfluenza komplikasyonlar\u0131n\u0131 azaltmakta ve gereksiz antibiyotik kullan\u0131m\u0131n\u0131 engellemektedir.<\/p>\n
![\"\"](\"https:\/\/tatd.org.tr\/tatdtoks\/wp-content\/uploads\/sites\/36\/2021\/10\/315-1.png\")
<\/p>\n
\u015eekil.<\/strong><\/u> \u0130nfluenza vaka y\u00f6netimi algoritmas\u0131 (kaynak i\u00e7in T\u0131klay\u0131n\u0131z<\/a>)<\/p>\n<\/h3>\nKaynaklar:<\/h3>\n\n- \u00a0Haftal\u0131k \u0130nfluenza (Grip) Surveyans Raporu. grip.gov.tr.\u00a0https:\/\/grip.gov.tr\/depo\/influenza-raporu\/2019\/Haftalk_nfluenzaGrip_Srveyans_Raporu_2020_1._hafta.pdf<\/a>.<\/li>\n
- Muthuri, Stella G., et al. “Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data.”\u00a0The lancet Respiratory medicine<\/em>\u00a02.5 (2014): 395-404.<\/li>\n
- Louie, Janice K., et al. “Neuraminidase inhibitors for critically ill children with influenza.”\u00a0Pediatrics<\/em>\u00a0132.6 (2013): e1539-e1545.<\/li>\n
- http:\/\/www.kansensho.or.jp\/uploadshttp:\/\/tatdtoksikoloji.org\/files\/guidelines\/1812_endonuclease_en.pdf<\/a><\/li>\n
- Rosenberg, Matthew R., and Marco G. Casarotto. “Coexistence of two adamantane binding sites in the influenza A M2 ion channel.”\u00a0Proceedings of the National Academy of Sciences<\/em>\u00a0107.31 (2010): 13866-13871.<\/li>\n
- Uyeki TM, Bernstein HH, Bradley JS, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenzaa.\u00a0Clinical Infectious Diseases<\/em>. December 2018:e1-e47. doi:10.1093\/cid\/ciy866<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"
Son d\u00f6nemde say\u0131lar\u0131 art\u0131\u015f g\u00f6steren grip vakalar\u0131 acil servis ba\u015fvuru say\u0131lar\u0131nda da art\u0131\u015fa neden olmaktad\u0131r. Gribin en s\u0131k sebebi \u0130nfluenza grubu vir\u00fcslerdir.…<\/p>\n","protected":false},"author":1381,"featured_media":1882,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[10014],"tags":[62,198,199],"class_list":["post-946","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-akademik-blog-yazisi","tag-antiviral-ilaclar","tag-influenza","tag-influenza-tedavisi"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/posts\/946","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/users\/1381"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/comments?post=946"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/posts\/946\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/media\/1882"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/media?parent=946"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/categories?post=946"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/tags?post=946"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Grip hastal\u0131\u011f\u0131n\u0131n tedavisinde kullan\u0131m\u0131 ise ya\u015flara g\u00f6re de\u011fi\u015fir.\u00a0 T\u00fcrkiye\u2019 de ruhsatland\u0131rma ile prospekt\u00fcs bilgilerine g\u00f6re yeti\u015fkinler ve ergenler taraf\u0131ndan 75 mg kaps\u00fcle veya alternatif olarak bir adet 30 mg kaps\u00fcl ile bir adet 45 mg kaps\u00fcl kullan\u0131labilir. Sabah ak\u015fam g\u00fcnde\u00a0iki kez 75 mg, 5 g\u00fcn s\u00fcre<\/strong>\u00a0ile kullan\u0131l\u0131r. 5 g\u00fcnl\u00fck tedaviyi tamamlamak gerekir.\u00a0 1- 12 ya\u015f aras\u0131nda \u00e7ocuklarda kullan\u0131mda kaps\u00fcl yerine oral s\u00fcspansiyon tozu kullan\u0131labilir. 40 kg\u2019dan fazla ve kaps\u00fcl yutabilen \u00e7ocuklar 5 g\u00fcn boyunca g\u00fcnde iki defa\u00a0Oseltamivir<\/strong>\u00a075 mg kaps\u00fcl kullanabilirler.<\/p>\n Prospekt\u00fcs bilgilerine g\u00f6re \u00e7ocuklarda influenza tedavi \u015femas\u0131 a\u015fa\u011f\u0131daki gibidir.<\/p>\n Oseltamivir<\/strong>\u00a0ayr\u0131ca grip hastal\u0131\u011f\u0131n\u0131n \u00f6nlenmesinde kullan\u0131labilir.\u00a0 Ergenlerde (13-17 ya\u015f) ve yeti\u015fkinlerde kullan\u0131mda tedavide oldu\u011fu gibi 75 mg kaps\u00fcl veya alternatif olarak 1 adet 30 mg kaps\u00fcl ile 1 adet 45 mg kaps\u00fcl kullan\u0131labilir. Tedavi dozundan farkl\u0131 olarak\u00a0Oseltamivir<\/strong>\u00a0profilaksi amac\u0131yla 10 g\u00fcn boyunca,\u00a0g\u00fcnde bir kez 75 mg<\/strong>\u00a0al\u0131nmal\u0131d\u0131r. Bu dozu sabah kahvalt\u0131s\u0131yla birlikte almak en uygun yoldur.\u00a0 1 ya\u015f \u00fcst\u00fc bebeklerle 2-12 ya\u015f aras\u0131 \u00e7ocuklarda kullan\u0131mda v\u00fccut a\u011f\u0131rl\u0131\u011f\u0131na g\u00f6re \u015femas\u0131 vard\u0131r. Kaps\u00fcl yerine oral s\u00fcspansiyon tozu kullan\u0131labilir.<\/p>\n \u00c7ocuklarda \u0130nfluenza profilaksisinde kullan\u0131m \u015femas\u0131 a\u015fa\u011f\u0131dad\u0131r.<\/p>\n Oseltamivir\u00a0<\/strong>i\u00e7eren ila\u00e7lar ve e\u015fde\u011ferlerine bu linkten ula\u015fmak i\u00e7in t\u0131klay\u0131n\u0131z<\/a>.<\/p>\n Oseltamivir<\/strong>\u00a0En \u00f6nemli yan etkisi, bulant\u0131, kusmad\u0131r (%10-15). Oseltamivir kullan\u0131m\u0131 s\u0131ras\u0131nda Japon adolesanlarda ge\u00e7ici n\u00f6ropsikiyatrik olaylar geli\u015fti\u011fi de bildirilmi\u015ftir. Bu nedenle FDA, oseltamivir kullananlar\u0131n davran\u0131\u015f bozuklu\u011fu a\u00e7\u0131s\u0131ndan yak\u0131n takibini \u00f6nermektedir.<\/p>\n Allerjik reaksiyonlar, orofaringeal ve fasiyal \u00f6dem bildirilmi\u015f olup bunun d\u0131\u015f\u0131nda en s\u0131k saptanan yan etkiler; diyare, bulant\u0131, sin\u00fczit, nazal bulgu ve semptomlar, bron\u015fit, \u00f6ks\u00fcr\u00fck, ba\u015f a\u011fr\u0131s\u0131, ba\u015f d\u00f6nmesi olarak belirtilmi\u015ftir.<\/p>\n Gebelikte N\u00f6raminidaz inhibit\u00f6rlerinin kullan\u0131mda dikkatli olunmas\u0131 gerekir. Gebelik kategorisi C olarak bildirilmi\u015ftir.<\/p>\n Endon\u00fckleaz inhibit\u00f6rlerinin etkileri n\u00f6raminidaz inhibit\u00f6rlerine g\u00f6re daha farkl\u0131d\u0131r. Endon\u00fckleaz inhibitorleri viral RNA transkripsiyonunu bozar ve viral replikasyonu engelleyerek influenza A and B vir\u00fcslerini \u00f6ld\u00fcr\u00fcr. FDA onayl\u0131 tek cap-dependent endon\u00fckleaz inhibitor\u00fc ila\u00e7 olarak\u00a0Baloxavir marboxil<\/strong>\u00a0(Xofluza\u00ae) mevcut (4). Oral kullan\u0131m i\u00e7in onayl\u0131 bir ila\u00e7t\u0131r.\u00a0 \u0130nfluenzan\u0131n erken d\u00f6neminde 12 ya\u015f \u00fczerinde uygun bulunmu\u015ftur. \u00a0Baloxavir marboxil<\/strong>\u00a0 \u00a0gebeler, lohusalar, komplike hastal\u0131klarda \u00f6nerilmez.<\/p>\n Adamantan grubu influenza A vir\u00fcslerindeki M2 iyon kanallar\u0131n\u0131 hedef olarak al\u0131rlar. Bu y\u00fczden sadece \u0130nfluenza A tipinde etkilidirler. ABD\u2019 de vir\u00fcslerde ilaca kar\u015f\u0131 diren\u00e7 geli\u015fti\u011fi i\u00e7in \u00f6nerilmiyorlar (5). \u00a0\u0130ki jenerik ila\u00e7 mevcut. \u0130lki\u00a0Amantadine<\/strong>\u00a0(jenerik) olup oral kullan\u0131lan FDA onayl\u0131 bir ila\u00e7. Sadece influenza A hastalar\u0131nda ve 1 ya\u015f \u00fczerindekilerde kullan\u0131l\u0131r.\u00a0Rimantadine<\/strong>\u00a0(jenerik veya Flumadine\u00ae) ise di\u011fer grup \u00fcyesidir. FDA onayl\u0131 oral uygulanan ve influenza A\u2019 da etkili antiviral ila\u00e7t\u0131r. Sadece 17 ya\u015f \u00fczerinde kullan\u0131l\u0131r.<\/p>\n Bu grubun en \u00f6nemli yan etkileri; geri-d\u00f6n\u00fc\u015f\u00fcml\u00fc n\u00f6rotoksisite (uykusuzluk, anksiyete, ba\u015f d\u00f6nmesi, konsantrasyon bozuklu\u011fu, konf\u00fczyon, konv\u00fclziyon, hal\u00fcsinasyon), epilepsi, renal kreatinin klerensinin azalmas\u0131d\u0131r. Eri\u015fkinde \u00f6nerilen tedavi s\u00fcresi 3-5 g\u00fcn olup tedavi ve profilakside \u00f6nerilen doz: 1x200mg\/ g\u00fcn PO veya 2x100mg\/g\u00fcn PO. \u00a0Tedavi s\u0131ras\u0131nda diren\u00e7 geli\u015fimi en b\u00fcy\u00fck sorundur. Adamantanlarda n\u00f6raminidaz inhibit\u00f6rleri gibi gebelik kategorisi C\u2019de bulunur.<\/p>\n Asl\u0131nda \u0130nfluenzay\u0131 \u00f6nlemenin en etkili yolu\u00a0grip a\u015f\u0131s\u0131 yap\u0131lmas\u0131 ve el y\u0131kama\u00a0gibi basit enfeksiyon kontrol \u00f6nlemlerini kullanmakt\u0131r. ABD Hastal\u0131k\u00a0Kontrol ve\u00a0\u00d6nleme Merkezi 6 ayl\u0131ktan b\u00fcy\u00fck t\u00fcm bireylerin hastal\u0131k sezonu \u00f6ncesi yani Ekim ay\u0131 sonuna kadar kontrendikasyonu olmayan ki\u015filerde a\u015f\u0131lanma yap\u0131lmas\u0131n\u0131 \u00f6nermekte.<\/p>\n Ancak hastal\u0131k geli\u015ftikten sonra ise antiviral tedaviyi kimlere ba\u015flayaca\u011f\u0131m\u0131z\u0131 bilmemiz gerekiyor. Kan\u0131tlanm\u0131\u015f veya \u015f\u00fcpheli grip olan yeti\u015fkinler ve \u00e7ocuklara m\u00fcmk\u00fcn olan en k\u0131sa s\u00fcrede antiviral tedaviye ba\u015flamal\u0131d\u0131r. Ayr\u0131ca a\u015f\u0131 olup olmad\u0131\u011f\u0131na bak\u0131lmaks\u0131z\u0131n influenza tan\u0131s\u0131 kesinle\u015fmi\u015f yat\u0131\u015f verilen hastalarda hastal\u0131k s\u00fcresine bak\u0131lmaks\u0131z\u0131n; ciddi ve ilerleyici hastal\u0131\u011f\u0131 olan yine hastal\u0131k s\u00fcresinden ba\u011f\u0131ms\u0131z olarak ayaktan hastalara; kronik hastal\u0131k \u00f6yk\u00fcs\u00fc olan ve imm\u00fcn yetmezlik tablosu olan hastalara; <2 ya\u015f ve 65 ya\u015f< b\u00fct\u00fcn hastalara; gebeler ve postpartum 2. Haftaya kadar olan hastalara antiviral tedavi ba\u015flanmal\u0131d\u0131r (6).<\/p>\n Antiviral ila\u00e7 tedavisinin Acil T\u0131p uzmanlar\u0131 taraf\u0131ndan erken ba\u015flanmas\u0131 \u00f6nemlidir \u00e7\u00fcnk\u00fc bu tedavi; semptomlar\u0131n s\u00fcresini ve \u015fiddetini, vir\u00fcs yay\u0131lmas\u0131n\u0131, hospitalizasyon ihtiyac\u0131n\u0131, tedavi maliyetini, \u0130nfluenza komplikasyonlar\u0131n\u0131 azaltmakta ve gereksiz antibiyotik kullan\u0131m\u0131n\u0131 engellemektedir.<\/p>\n \u015eekil.<\/strong><\/u> \u0130nfluenza vaka y\u00f6netimi algoritmas\u0131 (kaynak i\u00e7in T\u0131klay\u0131n\u0131z<\/a>)<\/p>\n Son d\u00f6nemde say\u0131lar\u0131 art\u0131\u015f g\u00f6steren grip vakalar\u0131 acil servis ba\u015fvuru say\u0131lar\u0131nda da art\u0131\u015fa neden olmaktad\u0131r. Gribin en s\u0131k sebebi \u0130nfluenza grubu vir\u00fcslerdir.…<\/p>\n","protected":false},"author":1381,"featured_media":1882,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[10014],"tags":[62,198,199],"class_list":["post-946","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-akademik-blog-yazisi","tag-antiviral-ilaclar","tag-influenza","tag-influenza-tedavisi"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/posts\/946","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/users\/1381"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/comments?post=946"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/posts\/946\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/media\/1882"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/media?parent=946"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/categories?post=946"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/toksikoloji\/wp-json\/wp\/v2\/tags?post=946"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}<\/p>\n<\/p>\n\n
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\u00a0 \u00a0 \u00a0<\/strong><\/h2>\n
\u00a0 \u00a0 \u00a0 2. Cap-dependent Endon\u00fckleaz \u0130nhibit\u00f6rleri<\/strong><\/h2>\n
\u00a0 \u00a0 \u00a0 <\/strong><\/h2>\n
\u00a0 \u00a0 \u00a0 3. Adamantan grubu<\/strong><\/h2>\n
<\/h2>\n
Kime Antiviral Tedavi?<\/strong><\/h2>\n
<\/h2>\n
Son S\u00f6z<\/strong><\/h2>\n
<\/p>\n<\/h3>\n
Kaynaklar:<\/h3>\n
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