Antivenomlar ve uygulama ilkeleri

Yıl 2020, Cilt: 34 Sayı: 1, 73 - 83, 07.04.2020

Mukaddes Gümüştekin Barış Sarıçoban Muharrem Gürkan

https://doi.org/10.5505/deutfd.2020.15238

Cited By: 1

Öz

Zehirli hayvanlarla temas ve ısırılma nedeni ile zehirlenme ve ölüm özellikle gelişmekte olan ülkelerde bir halk sağlığı sorunudur. Dünya genelinde 1,8-2,7 milyon yılan ısırması ve 81 bin ile 137 bin arasında ölüm bildirilmiştir. Yine benzer oranlarda akrep sokması vakası bildirilmiş olup, bildirilen vakalarda ölüm oranı yılan ısırmalarına kıyasla belirgin olarak düşüktür. Antivenomlar, zehirli hayvanların venomuna karşı üretilen antikor preparatlarıdır. On dokuzuncu yüzyıldan bu yana üretilmeye başlanan antivenomların etkililiği konusunda tartışmalı bulguların olması, anaflaksi gibi alerjik reaksiyonlara neden olabilmeleri ve yapılan çalışmaların randomize kontrollü çalışmalar olmaması nedeniyle elde edilen verilerin tüm zehirlenmelere ekstrapole edilemeyeceğini düşündürmektedir. Türkiye’de yılan ısırmalarına ve akrep sokmalarına karşı üretilen antivenomlar bulunmaktadır. Ancak örümcek antivenomu bulunmamaktadır. Ayrıca, zehirlenmeler ve tedavileri ile ilgili eğitim eksikliği nedeniyle, gerekmeyen olgularda da antivenom kullanıldığı görülmektedir. Bu nedenle, ısırma ve sokmaların yönetiminde antivenom kullanımı ile ilgili bilgilerin güncellenmesi önemlidir. Bu makalede ülkemizde sık görülen yılan, akrep ve örümcek sokmalarına karşı antivenom uygulama ilkelerinden bahsedilecektir.

Anahtar Kelimeler

akrep sokmaları, örümcek ısırmaları, antivenom, yılan ısırmaları

ANTIVENOMS AND PRINCIPLES OF APPLICATION

Öz

Venomous animals bites, stings, and poisoning are major public health problem in the developing countries. At least 1.8-2.7 million snake bite cases are reported annually around the world and between 81,000 and 137,000 deaths have been reported. Scorpion sting was reported in similar proportions as snake bites, and the mortality rate in the reported cases was significantly lower than in snake bites. Antivenoms are antibody preparations produced against venom of venomous animals. The antivenoms have been produced since the nineteenth century. However, it is suggested that the data obtained cannot be extrapolated to all poisonings due to controversial findings about the efficacy of antivenoms, allergic reactions of antivenoms use such as anaphylaxis and the lack of randomized controlled trials on antivenoms. There are antivenoms produced against snake bites and scorpion stings in Turkey, but no antivenoms against spider bites. It is observed that antivenoms are used inappropriately due to lack of education related to poisonings and their treatment. Thus, it is important to update the information about the use of antivenoms in the management of bites and stings. In this review, antivenom practice principles in animal bites and stings in Turkey will be discussed in general.

Anahtar Kelimeler

antivenom, snake bites, scorpion stings, spider bites

Kaynakça

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