TY  - JOUR
T1  - Kininler ve romatizmal hastalıklar
TT  - Quinines and rheumatic diseases
AU  - Nalbant, Selim
PY  - 2021
DA  - January
JF  - Ege Tıp Dergisi
JO  - EJM
PB  - Ege University
WT  - DergiPark
SN  - 1016-9113
SP  - 70
EP  - 76
LA  - tr
AB  - Kına kına ağacından elde edilen kininlerin sıtmada kullanılmalarına ait serüven ve sonrasında olanlarne kadar ilginç ise ilk defa romatizmal hastalıklarda kullanılmaları da o kadar ilginçtir. İkinci DünyaSavaşında sıtmaya yakalanıp kinin ile tedavi edilen romatoid artritli Amerikalı askerlerin romatoidartritlerinin iyileştiğinin fark edilmesinin, kininlerin romatizmal hastalıklarda kullanılmasına nedenolduğu söylenir. Kininlerin romatolojik hastalıklarda Klorokin (Chloroquine), Kinakrin (Quinacrine) veHidroksiklorokin (Hydroxychloroquine) formları kullanılır. Anti-malaryaller romatolojik hastalıklardasıklıkla kullanılan, GİS (gastrointestinal sistem) emilimi çok iyi, güvenli, oldukça etkili ve 2-3 ay gibiuzun etkili ilaçlardır. Esas olarak hem kendisi hem de hepatik metabolitleri böbrekten atıldıkları içinrenal fonksiyonlar azaldığında doz azaltılması gerekir. Anti-inflamatuar etkileri pek çok noktada oluşurancak hangisi temel mekanizmadır bugün için bilinmemektedir. Hipoglisemik etkileri vardır. Bu etkibazı olgularda önemli olabilir. Alerjik cilt reaksiyonları, psikozis, epilepsi benzeri ataklar, miyopati veretinal hasarlar gibi ciddi yan etkiler oldukça nadirdir. Daha sık görülenler bulantı-kusma ve dispepsigibi GİS yan etkileridir. Göz kontrolü tedaviye başlamadan önce mutlaka yapılıp, ilk beş yılda kontrolperiyodları bireyselleştirilmeli, beş yıldan sonra en az yılda bir yapılmalıdır. Olgu 80 kg üzerinde isegünlük 400 mg başlangıç doz ile başlanabilir. 80 kg altında 5 mg/kg doz üstüne çıkılmazsa oküler verenal yan etkiler nadirdir. Gebelikte renal fonksiyonlar normal olduğunda güvenle kullanılabilir.
KW  - Kininler
KW  - 
KW  - inflamasyon
KW  - göz yan etkileri
N2  - Using of the quinines in rheumatic diseases for the first time is interesting as much as the adventure ofthe use of quinines obtained from the Cinchona tree for malaria. American soldiers with rheumatoidarthritis who were infected with malaria and treated with quinine in the Second World War werereported to have recovered from rheumatoid arthritis. Quinines, used in rheumatologic diseases, areChloroquine, Quinacrine and Hydroxychloroquine. GIS (gastrointestinal system) absorption of antimalarials commonly used in rheumatologic diseases is very good, safe, and highly effective and longacting such as 2-3 months. Because both quinine and its hepatic metabolites are excreted from thekidney, the dose should be reduced when renal function decreases. Anti-inflammatory effects occur atmany points, but which is the main mechanism is not known for today. It has hypoglycemic effects.This effect may be important in some cases. Serious side effects such as allergic skin reactions,psychosis, epilepsy-like seizures, myopathy, and retinal damage are extremely rare. More commonare GIS side effects such as nausea, vomiting and dyspepsia. Ophthalmologic examination must beperformed before starting treatment and control periods should be individualized in the first 5 yearsand after 5 years at least once a year. If the case is over 80 kg, it can be started with an initial dose of400 mg per day. It can also be used safely when renal functions are normal during pregnancy.
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UR  - https://dergipark.org.tr/en/pub/etd/article/864171
L1  - https://dergipark.org.tr/en/download/article-file/1519543
ER  -