OPİOİD İLAÇ KULLANAN HASTALARDA GELİŞEN KONSTİPASYONUN YÖNETİMİ

Year 2019, Volume: 8 Issue: 1, 27 - 32, 30.04.2019

Dilek Yıldırım Gülbeyaz Can

Abstract

Opioidler
ağrı tedavisinde sık kullanılmaktadır. Opioidlerin analjezik etkisinin yanında
bazı yan etkileri de vardır. En yaygın görülen ve hastalar tarafından
tanımlanan en rahatsız edici yan etkisi konstipasyondur. Hastaların yaşam
kalitesini ve tedaviye uyumunu olumsuz yönde etkileyen konstipasyon, sağlık
bakım maliyetlerini arttırmakta, hastanede kalış süresini uzatmakta, hastane
başvurularını arttırmakta, tedavi dozlarının atlanmasına, azaltılmasına hatta
tedavinin sonlanmasına neden olabilmektedir. Konstipasyon yönetiminde laksatif,
lavman, opioid reseptör antagonistleri gibi farmakalojik yaklaşımlar,  hasta eğitimi, sıvı ve lif alımını arttırma,
egzersiz, abdominal masaj gibi nonfarmakolojik yaklaşımlar önerilmektedir.
Ancak literatürde opioid ilişkili konstipasyon yönetiminde etkili bir bakım
protokolü tanımlanamamıştır. Literatür verileri ışığında, opioid ilaç tedavisi
olan hastalar mutlaka rutin olarak konstipasyon açısından değerlendirilmeli ve
opioid ilişkili konstipasyon yönetimine yönelik klinik protokoller
oluşturulmalıdır. Sağlık bakım ekibi opioid ilişkili konstipasyon ve yönetimi
konusunda bilgilendirilmelidir. Opioid ilişkili konstipasyon yönetiminde yer
alan yaklaşımların etkinliğini değerlendirecek randomize kontrollü çalışmalara
gereksinim vardır. Bu derleme, sağlık ekibinin opioid ilişkili konstipasyona
yönelik bilgi düzeylerinin ve farkındalığının arttırılması amacıyla
yapılmıştır.

Keywords

Ağrı tedavisi, Opioidler, Opioid ilişkili konstipasyon, Konstipasyon yönetim

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