{"id":3520,"date":"2009-01-27T09:23:45","date_gmt":"2009-01-27T07:23:45","guid":{"rendered":"http:\/\/www.ced.org.tr\/?p=3520"},"modified":"2009-01-27T09:23:45","modified_gmt":"2009-01-27T07:23:45","slug":"son-yapilan-teblig-degisiklikleri-nedeniyle-meslektaslarimizin-dikkat-etmesi-gereken-hususlar","status":"publish","type":"post","link":"http:\/\/www.ced.org.tr\/?p=3520","title":{"rendered":"Son yap\u0131lan Tebli\u011f de\u011fi\u015fiklikleri nedeniyle meslekta\u015flar\u0131m\u0131z\u0131n dikkat etmesi gereken hususlar"},"content":{"rendered":"

31.12.2008 tarihinde Resmi Gazete\u2019de yay\u0131mlanan \u201c2008 y\u0131l\u0131 SGK Sa\u011fl\u0131k Uygulama Tebli\u011finde De\u011fi\u015fiklik Yap\u0131lmas\u0131na Dair Tebli\u011f\u201d ve 20.01.2009 tarihli Resmi Gazete\u2019de yay\u0131mlanan \u201cTedavi Yard\u0131m\u0131na \u0130li\u015fkin Uygulama Tebli\u011fi\u201d ile yap\u0131lan de\u011fi\u015fiklikler nedeni ile meslekta\u015flar\u0131m\u0131z\u0131n dikkat etmesi gereken hususlar.<\/font> <\/p>\n

\u00a0\u00a0\u00a0 1-\u00a0<\/span><\/span><\/strong>Re\u00e7etelere yaz\u0131lacak ila\u00e7lar ile b\u00fcy\u00fck-k\u00fc\u00e7\u00fck ambalajlar\u0131n\u0131n \u00f6denmesine ili\u015fkin olarak; <\/strong><\/font><\/span><\/span><\/span><\/span><\/p>\n

Ayn\u0131 dozda bir<\/span><\/strong> veya birden fazla<\/span><\/strong> formu olan ila\u00e7lar\u0131n \/ e\u015fde\u011fer ila\u00e7lar\u0131n (maksimum dozlar\u0131 da dikkate al\u0131narak) 30 g\u00fcnl\u00fck tedavi<\/span> <\/strong>dozunu ge\u00e7en ambalaj formlar\u0131 i\u00e7in sa\u011fl\u0131k\u00a0raporu\u00a0d\u00fczenlenmesi zorunludur.\u00a0<\/font><\/span><\/span><\/span><\/span><\/p>\n

<\/span><\/span><\/span><\/p>\n

Bu nedenle ilac\u0131n piyasada tek bir formu bulunsa bile re\u00e7etede yaz\u0131lan miktar\u0131 30<\/span><\/strong> g\u00fcnl\u00fck tedavi s\u00fcresini<\/span><\/strong> <\/span>\u00a0<\/span>a\u015f\u0131yor ise ilac\u0131n \u00f6denebilmesi i\u00e7in rapor gereklidir. <\/font><\/span><\/span><\/span><\/span><\/p>\n

<\/span><\/span><\/span><\/p>\n

2-\u00a0<\/span><\/span><\/strong>Osteoporoz\u2019da ila\u00e7 kullan\u0131m ilkelerine ili\u015fkin olarak;<\/strong><\/font><\/span><\/span><\/span><\/span><\/p>\n

a.\u00a0<\/span><\/span><\/strong>Osteoporoz tedavisinde kullan\u0131lan bifosfonatlar ve di\u011fer osteoporoz ila\u00e7lar\u0131 (raloksifen, calcitonin, stronsiyum ranelat) \u00a0<\/span>a\u015fa\u011f\u0131daki belirtilen ICD-10 kodu ile tan\u0131ml\u0131 endikasyonlar da ve tebli\u011fde belirtilen ko\u015fullarla \u00f6denir.<\/span><\/strong> <\/span><\/font><\/span><\/span><\/span><\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/font><\/span><\/span><\/span><\/span><\/span><\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>(Kat\u0131l\u0131m payl\u0131)<\/font><\/span><\/span><\/span><\/span><\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>M80.0\u00a0 <\/span>\u00a0\u00a0<\/span>Postmenopozal Osteoporoz ,Patolojik K\u0131r\u0131k \u0130le<\/font><\/span><\/span><\/span><\/span><\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>M81.0\u00a0\u00a0\u00a0 <\/span>Postmenopozal Osteoporoz , Patolojik K\u0131r\u0131ks\u0131z<\/font><\/span><\/span><\/span><\/span><\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>M81.8\u00a0\u00a0\u00a0 <\/span>Senil Osteoporoz<\/font><\/span><\/span><\/span><\/span><\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>M80.1\u00a0\u00a0\u00a0 <\/span>Cerrahi Sonras\u0131 Osteoporoz , Patolojik K\u0131r\u0131k \u0130le<\/font><\/span><\/span><\/span><\/span><\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>M81.1\u00a0\u00a0\u00a0 <\/span>Cerrahi Sonras\u0131 Osteoporoz,\u00a0 <\/span>Patolojik K\u0131r\u0131ks\u0131z<\/font><\/span><\/span><\/span><\/span><\/span><\/p>\n

<\/span><\/span><\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>(Kat\u0131l\u0131m pays\u0131z)\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/font><\/span><\/span><\/span><\/span><\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>\u00a0\u00a0 <\/span>M80.4\u00a0\u00a0\u00a0 <\/span>\u0130laca Ba\u011fl\u0131 Osteoporoz, Patolojik K\u0131r\u0131k \u0130le<\/font><\/span><\/span><\/span><\/span><\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>M81.4\u00a0\u00a0\u00a0 <\/span>\u0130laca Bagl\u0131 Osteoporoz, Patolojik K\u0131r\u0131ks\u0131z<\/font><\/span><\/span><\/span><\/span><\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>M89.0\u00a0\u00a0\u00a0 <\/span>Sudeck Atrofisi<\/font><\/span><\/span><\/span><\/span><\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>M88\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>Paget Hastal\u0131\u011f\u0131<\/font><\/span><\/span><\/span><\/span><\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>Q78.0\u00a0\u00a0\u00a0 <\/span>Osteogenez\u0131s Imperfekta<\/font><\/span><\/span><\/span><\/span><\/span><\/p>\n

<\/span><\/span><\/span><\/p>\n

b.\u00a0<\/span><\/span><\/strong>Bu ila\u00e7lar mutlaka uzman hekimler<\/span> <\/strong>taraf\u0131ndan re\u00e7etelendirilmelidirler.<\/font><\/span><\/span><\/span><\/span><\/p>\n

<\/span><\/span><\/span><\/p>\n

3-\u00a0<\/span><\/span><\/strong>Lipid d\u00fc\u015f\u00fcr\u00fcc\u00fc ila\u00e7lar\u0131n kullan\u0131m\u0131na ili\u015fkin olarak;<\/font><\/span><\/span><\/span><\/span><\/p>\n

a.\u00a0<\/span><\/span><\/strong>Statinler ve statin d\u0131\u015f\u0131ndaki lipid d\u00fc\u015f\u00fcr\u00fcc\u00fc ila\u00e7lar\u0131n tebli\u011fde belirtilen LDL ve trigliserit d\u00fczeylerinde \u00f6denebilmesi i\u00e7in belirtilen hastal\u0131k gruplar\u0131na (diabetes mellitus, akut koroner sendrom, ge\u00e7irilmi\u015f MI, ge\u00e7irilmi\u015f inme, koroner arter hastal\u0131\u011f\u0131, periferik arter hastal\u0131\u011f\u0131, abdominal aort anevrizmas\u0131 veya karotid arter hastal\u0131\u011f\u0131,65 ya\u015f ve \u00fczerindeki hipertansiyon) ait sa\u011fl\u0131k raporunun re\u00e7eteye eklenmesi gerekmektedir. <\/span><\/strong><\/font><\/span><\/span><\/span><\/span><\/p>\n

b.\u00a0<\/span><\/span><\/strong>Bu ila\u00e7lar raporland\u0131r\u0131l\u0131rken ilk uzman hekim raporuna son 6 ayda yap\u0131lm\u0131\u015f, kan lipid d\u00fczeylerinin y\u00fcksek oldu\u011funu g\u00f6steren tetkik eklenir veya bu tetkik sonu\u00e7lar\u0131 raporda belirtilir. (Tetkik sonucu ya raporda yazacakt\u0131r ya da rapora ilgili tetkik eklenmelidir.)<\/font><\/span><\/span><\/span><\/span><\/p>\n

c. <\/span><\/strong>Tetkik sonu\u00e7lar\u0131 mutlaka cihaz \u00e7\u0131kt\u0131s\u0131 olmal\u0131d\u0131r, el yaz\u0131s\u0131 ile yaz\u0131lm\u0131\u015f sonu\u00e7lar dikkate al\u0131nmaz.<\/font><\/span><\/span><\/span><\/span><\/p>\n

4-\u00a0<\/span><\/span><\/span><\/strong>Sadece barsak operasyonundan olu\u015fan malabsorbsiyonlar ve malnutrisyon raporuna muaf i\u015flemi yap\u0131lmal\u0131d\u0131r. Her malnutrisyon raporuna\u00a0 <\/span>muaf i\u015flemi yap\u0131lamayacakt\u0131r.<\/span><\/font><\/span><\/span><\/span><\/span><\/p>\n

5-\u00a0<\/span><\/span><\/strong>Kontraseptiflerin ; prospekt\u00fcs\u00fcnde yer alan kontrasepsiyon d\u0131\u015f\u0131ndaki tedavi endikasyonlar\u0131nda \u00f6demesi yap\u0131lmaktad\u0131r.<\/span><\/font><\/span><\/span><\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

31.12.2008 tarihinde Resmi Gazete\u2019de yay\u0131mlanan \u201c2008 y\u0131l\u0131 SGK Sa\u011fl\u0131k Uygulama Tebli\u011finde De\u011fi\u015fiklik Yap\u0131lmas\u0131na Dair Tebli\u011f\u201d ve 20.01.2009 tarihli Resmi Gazete\u2019de...<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3520","post","type-post","status-publish","format-standard","hentry","category-ced"],"aioseo_notices":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=\/wp\/v2\/posts\/3520","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3520"}],"version-history":[{"count":0,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=\/wp\/v2\/posts\/3520\/revisions"}],"wp:attachment":[{"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3520"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3520"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3520"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}