Ototoksitede en s\u0131k semptom kulak \u00e7\u0131nlamas\u0131d\u0131r (tinnitus).<\/p>\n
Ototoksite riskini artt\u0131ran durumlar:<\/p>\n
B\u00f6brek yetmezli\u011fi<\/p>\n
Karaci\u011fer yetmezli\u011fi<\/p>\n
Ba\u011f\u0131\u015f\u0131kl\u0131k yetersizli\u011fi<\/p>\n
\u0130leri ya\u015f<\/p>\n
Ototoksite \u00f6yk\u00fcs\u00fc<\/p>\n
Ototoksik ajanlar\u0131n birlikte kullan\u0131m\u0131<\/p>\n
G\u00fcr\u00fclt\u00fcye maruz kalma<\/p>\n
\u00d6nceden NS\u0130K olmas\u0131<\/p>\n
Kollejen vask\u00fcler hastal\u0131klar<\/p>\n
En az ototoksik aminoglikozit(AG) Netilmisin’dir.<\/p>\n
AG ototoksitesi g\u00f6zlenen hastalar\u0131n yar\u0131s\u0131ndan fazlas\u0131nda 1 hafta \u0096 6 ay aras\u0131nda d\u00fczelme olur.<\/p>\n
AG tedavisi kesildikten 2-3 hafta sonra d\u00fczelme olmam\u0131\u015fsa kal\u0131c\u0131 hasar riski y\u00fcksektir.<\/p>\n
Osilopsi:<\/strong> Vestib\u00fcler fonksiyonlar\u0131n total bilateral yoklu\u011fu sonucu olu\u015fur. Ok\u00fclomotor fonksiyon kayb\u0131 vard\u0131r.<\/p>\n Dihidrostreptomisin:<\/p>\n Dozdan ba\u011f\u0131ms\u0131z olarak \u015fiddetli kokleotoksik etkisi vard\u0131r.<\/p>\n Klinik kullan\u0131m\u0131 yoktur.<\/p>\n Streptomisin:<\/p>\n Vestib\u00fclotoksiktir.<\/p>\n Hastalar\u0131n %60-70’inde vestib\u00fcler semptomlar 14 g\u00fcn 2 gr ila\u00e7 kullan\u0131m\u0131ndan sonra ortaya \u00e7\u0131kar.<\/p>\n \u00c7ocuk dozu 15-30 mg\/kg\/g\u00fcn’d\u00fcr.<\/p>\n Gentamisin:<\/p>\n Vestib\u00fclotoksiktir.<\/p>\n Kanamisin:<\/p>\n Unilateral i\u015fitme kayb\u0131 yapma ihtimali en y\u00fcksek AG.<\/p>\n Kokleotoksik.<\/p>\n Tobramisin:<\/p>\n Kokleotoksik.<\/p>\n Amikasin:<\/p>\n \u00c7ok az kokleotoksik, vestib\u00fcler etkisi daha da az.<\/p>\n Unilateral i\u015fitme kayb\u0131 yapabilir.<\/p>\n Neomisin:<\/p>\n \u00c7ok kokleotoksik.<\/p>\n Parenteral kullan\u0131m\u0131 yok.<\/p>\n Neomisin, streptomisin, kanamisin ge\u00e7 d\u00f6nemde (1-2 hafta) kokleotoksik etkilerini g\u00f6sterebilir.<\/p>\n AG antimikrobial etkilerini 30s ribozomal alt birim \u00fczerinden g\u00f6sterirler.<\/p>\n AG’ler:<\/p>\n Mitokondri ve h\u00fccre membran\u0131 fosfolipidlerine ba\u011flanarak membran ge\u00e7irgenli\u011fini artt\u0131r\u0131rlar.<\/p>\n Bu etki h\u00fccre d\u0131\u015f\u0131na Mg kayb\u0131 yapar ve h\u00fccre \u00f6l\u00fcr.<\/p>\n Ayr\u0131ca aminoglikozitler Ca duyarl\u0131 K kanallar\u0131n\u0131 etkileyerek de ototoksik etki g\u00f6sterirler.<\/p>\n AG ayr\u0131ca O2 radikalleri ile de ototoksite yaparlar.<\/p>\n AG’ler Asyal\u0131larda daha \u00e7ok ototoksik etki g\u00f6sterirler.<\/p>\n AG’lere ailesel yatk\u0131nl\u0131k vard\u0131r.<\/p>\n AG toksitesine<\/p>\n Tip I h\u00fccreler Tip II h\u00fccrelere g\u00f6re<\/p>\n Bazal h\u00fccreler Apikal h\u00fccrelere g\u00f6re<\/p>\n D\u0131\u015f t\u00fcyl\u00fc h\u00fccreler \u0130\u00e7 t\u00fcyl\u00fc h\u00fccrelere g\u00f6re daha duyarl\u0131d\u0131r.<\/p>\n AG toksitesine duyarl\u0131l\u0131k:<\/p>\n Krista ampullaris > Makula utrik\u00fcli > Makula sakkuli<\/p>\n Deneysel olarak AG toksitesini azaltan maddeler:<\/p>\n Glutatyon<\/p>\n Tiroksin<\/p>\n Fosfomisin<\/p>\n a-lipoik asit<\/p>\n Beyin-k\u00f6kenli n\u00f6rotrofik fakt\u00f6r<\/p>\n N\u00f6rotrofin-3<\/p>\n 4-metilkatekol<\/p>\n \u0130ns\u00fclin ve d\u00f6n\u00fc\u015ft\u00fcr\u00fcc\u00fc b\u00fcy\u00fcme fakt\u00f6r\u00fc-a<\/p>\n Dizosilopin (N-metil-D-aspartat resept\u00f6r antagonisti)<\/p>\n Salisilatlar<\/p>\n Sisplatin:<\/p>\n Daha \u00e7ok kokleotoksik.<\/p>\n Hastalar\u0131n %7’sinde g\u00f6r\u00fcl\u00fcr.<\/p>\n \u0130\u015fitme kayb\u0131 dozla ili\u015fkili ve k\u00fcm\u00fclatiftir.<\/p>\n Tinnitus gelip ge\u00e7ici ve bilateraldir.<\/p>\n Ototoksik etki tedavi ba\u015flad\u0131ktan sonra 2 g\u00fcnde izlenir ve tedavi kesildikten 7 g\u00fcn sonra d\u00fczelir.<\/p>\n \u00c7ocuklarda i\u015fitme kayb\u0131 daha \u00e7ok g\u00f6r\u00fcl\u00fcr bu \u00e7ocuklar\u0131n daha \u00e7ok kranial RT almas\u0131na ba\u011flanm\u0131\u015ft\u0131r.<\/p>\n Karboplatin:<\/p>\n Kokleotoksiktir (daha az).<\/p>\n \u0130\u015fitme kayb\u0131 dozla ili\u015fkili ve k\u00fcm\u00fclatiftir.<\/p>\n \u0130\u015fitme kayb\u0131 8000-12000 Hz’dedir.<\/p>\n Sisplatin ototoksitesini azaltan ajanlar:<\/p>\n Lazaroidler (serbest O2 radikalleri temizleyiciler)<\/p>\n Sodyom tiyos\u00fclfat<\/p>\n Fosfomisin (phosphonic asit antibiotic)<\/p>\n Dietilditiokarbamat<\/p>\n Ebselen<\/p>\n Lipoik asit<\/p>\n 4-metiltiobenzoik asit<\/p>\n Metalloenzim inhibit\u00f6rleri<\/p>\n D-metionin<\/p>\n B vitamini<\/p>\n Loop di\u00fcretiklerden<\/p>\n Etikrinik asit %0.7<\/p>\n Bumetanid %1.1<\/p>\n Furosemid %6.4 i\u015fitme kayb\u0131 yapar.<\/p>\n Furosemid ge\u00e7ici, Etikrinik asit ise kal\u0131c\u0131 i\u015fitme kayb\u0131 yapar.<\/p>\n Desferroksamin:<\/p>\n Talasami major ve Diamond-Blackfan anemisi hastalar\u0131nda \u00fcriner demir at\u0131l\u0131m\u0131 artt\u0131rmak i\u00e7in kullan\u0131l\u0131r.<\/p>\n %24 oran\u0131nda kokleotoksik etki g\u00f6sterir.<\/p>\n Antiinflematuar ila\u00e7lardan:<\/p>\n Salisilatlar<\/p>\n \u0130buprofen<\/p>\n Piroksikam i\u015fitme kayb\u0131 ve tinnitusa sebep olabilir.<\/p>\n Sadece topikal ajan kullan\u0131larak olu\u015fan ototoksite oran\u0131 %3.4’t\u00fcr.<\/p>\n Otomikoz tedavisinde klotrimazol, mikonazol veya tolnaftat g\u00fcvenle kullan\u0131labilir.<\/p>\n Siproflaksosin damlalar\u0131n\u0131n i\u00e7 kulakta hasar yapmad\u0131\u011f\u0131 g\u00f6sterilmi\u015ftir.<\/p>\n %0.3’l\u00fck oflaksosintopik sol\u00fcsyonu FDA onay\u0131 alan tek topikal ajand\u0131r.<\/p>\n Di\u011fer ototoksik ajanlar: Kenopodyum ya\u011f\u0131, karbonmonoksit, karbondis\u00fclfit, arsenik, kur\u015fun, civa, potasyum bromat, trikloretilen, toluen, sitiren, ksilen, benzol, bifosfonat, propanolol, bromkriptin, kinidin, kokain, heksan, pentobarbital, metalamin mandelat, tetanus antiserumu, y\u00fcksek doz ampisilin.<\/p>\n Eri\u015fkinlerde ototoksite erken tan\u0131s\u0131nda y\u00fcksek frekans odiyometri; \u00e7ocuklarda ise otoakustik emisyon kullan\u0131l\u0131r.<\/p>\n Kalorik testle olu\u015fmu\u015f nistagmusun yava\u015f faz\u0131nda azalma, erken vestib\u00fclotoksik etkilenmeyi g\u00f6sterebilir.<\/p>\n T\u00fcyl\u00fc h\u00fccrelerde hasar olu\u015ftu\u011funda sensorial epitel destek h\u00fccreler mitoz ve diferansiasyon ile yeni t\u00fcyl\u00fc h\u00fccreler olu\u015ftururlar.<\/p>\n","protected":false},"excerpt":{"rendered":" Ototoksitede en s\u0131k semptom kulak \u00e7\u0131nlamas\u0131d\u0131r (tinnitus). Ototoksite riskini artt\u0131ran durumlar: B\u00f6brek yetmezli\u011fi Karaci\u011fer yetmezli\u011fi Ba\u011f\u0131\u015f\u0131kl\u0131k yetersizli\u011fi \u0130leri ya\u015f Ototoksite \u00f6yk\u00fcs\u00fc Ototoksik ajanlar\u0131n birlikte kullan\u0131m\u0131 G\u00fcr\u00fclt\u00fcye maruz …<\/p>\n","protected":false},"author":1,"featured_media":3695,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[651,108,28,316,36],"class_list":["post-3694","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-kulak-burun-bogaz","tag-ajan","tag-asit","tag-etki","tag-hucre","tag-isitme-kaybi"],"_links":{"self":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/3694","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/comments?post=3694"}],"version-history":[{"count":1,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/3694\/revisions"}],"predecessor-version":[{"id":3696,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/3694\/revisions\/3696"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/media\/3695"}],"wp:attachment":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/media?parent=3694"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/categories?post=3694"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/tags?post=3694"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}