{"id":3945,"date":"2009-12-29T15:21:13","date_gmt":"2009-12-29T13:21:13","guid":{"rendered":"http:\/\/www.ced.org.tr\/?p=3945"},"modified":"2014-05-16T00:57:33","modified_gmt":"2014-05-15T21:57:33","slug":"ilac-seker-degildir-marketlerde-satilamaz-2","status":"publish","type":"post","link":"http:\/\/www.ced.org.tr\/?p=3945","title":{"rendered":"\u0130LA\u00c7 \u015eEKER DE\u011e\u0130LD\u0130R, MARKETLERDE SATILAMAZ"},"content":{"rendered":"

\u0130LA\u00c7, s\u0131radan bir t\u00fcketim maddesi de\u011fil, temel bir sa\u011fl\u0131k \u00fcr\u00fcnd\u00fcr. <\/span><\/p>\n

\u0130la\u00e7 kullan\u0131m\u0131 uzmanl\u0131k konusudur.<\/span><\/span><\/strong><\/p>\n

\u0130lac\u0131n se\u00e7imi t\u00fcketicinin tercihi ile de\u011fil konunun uzmanlar\u0131 taraf\u0131ndan yap\u0131l\u0131r.<\/span><\/p>\n

Hasta, ilac\u0131 hekim ve eczac\u0131\u2019n\u0131n kontrol\u00fc alt\u0131nda kullan\u0131r. <\/span><\/p>\n

\u0130lac\u0131n kullan\u0131ld\u0131\u011f\u0131 s\u00fcre zarf\u0131nda, hastan\u0131n yak\u0131n takibi \u00f6nemlidir. <\/span><\/p>\n

Eczac\u0131;<\/span><\/p>\n

\u2022<\/span>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span>Hastan\u0131n do\u011fru y\u00f6nlendirilmesinden,<\/span><\/span><\/p>\n

\u2022<\/span>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span>Hekimin \u00f6nerilerini hastaya eksiksiz ve do\u011fru bir \u015fekilde aktarmaktan sorumludur.<\/span><\/span><\/p>\n

Eczac\u0131, topluma ila\u00e7 ve sa\u011fl\u0131k dan\u0131\u015fman\u0131 olarak hizmet eder. <\/span><\/span><\/strong><\/p>\n

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

\u0130la\u00e7lar, yan etkiler veya istenmeyen di\u011fer etkiler nedeniyle, ba\u015fka sa\u011fl\u0131k sorunlar\u0131na yol a\u00e7ma bak\u0131m\u0131ndan her zaman bir risk potansiyeli ta\u015f\u0131maktad\u0131rlar <\/span><\/p>\n

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

T\u00fcm d\u00fcnyada yanl\u0131\u015f, gereksiz, etkisiz ve y\u00fcksek maliyetli ila\u00e7 kullan\u0131m\u0131 \u00e7e\u015fitli boyutlarda sorunlara neden olmaktad\u0131r.<\/span><\/p>\n

\u0130la\u00e7lar\u0131n toksisiteleri ve yan etkilerindeki belirgin art\u0131\u015f, bunlar\u0131n etkin ve minimum risk ile kullan\u0131lma zorunlulu\u011funu ve \u00f6zel bilgileri gerektirmektedir.<\/span><\/p>\n

B\u00f6ylece zaman i\u00e7erisinde, \u201cak\u0131lc\u0131 ila\u00e7 kullan\u0131m\u0131\u201d diye bir kavram ortaya \u00e7\u0131km\u0131\u015ft\u0131r.<\/span><\/p>\n

1985 y\u0131l\u0131nda Nairobi\u2019de yap\u0131lan D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc (DS\u00d6) toplant\u0131s\u0131nda ak\u0131lc\u0131 ila\u00e7 kullan\u0131m\u0131; \u201cki\u015filerin klinik bulgular\u0131na ve bireysel \u00f6zelliklerine g\u00f6re uygun ilac\u0131, uygun s\u00fcre ve dozajda, en d\u00fc\u015f\u00fck fiyata ve kolayca sa\u011flayabilmeleri\u201d \u015feklinde tan\u0131mlanm\u0131\u015ft\u0131r.<\/span><\/p>\n

Ak\u0131ll\u0131 \u0130la\u00e7 Kullan\u0131m\u0131nda ama\u00e7, toplum \u00fczerinde yanl\u0131\u015f ila\u00e7 kullan\u0131m\u0131ndan kaynaklanan ekonomik ve sosyal y\u00fck\u00fcn azalt\u0131lmas\u0131, fizyolojik, biyolojik ve psikolojik zararlar\u0131n \u00f6nlenmesidir.<\/span><\/p>\n

\u0130lac\u0131n yanl\u0131\u015f kullan\u0131m\u0131 bir\u00e7ok yeni problemlere yol a\u00e7ar.<\/span><\/span><\/strong><\/p>\n

Yanl\u0131\u015f tedavi, gerekli tedavinin zaman\u0131nda ba\u015flamas\u0131na engel olarak tedavinin ge\u00e7 kalmas\u0131na yola a\u00e7ar. Gerekli tedaviyi daha zorla\u015ft\u0131r\u0131r ve bazen de imkans\u0131z hale getirebilir.<\/span><\/p>\n

Yanl\u0131\u015f ila\u00e7 kullan\u0131m\u0131 ile yan etkiler, etkile\u015fimler, zehirlenmeler ve intiharlar gibi \u00e7ok tehlikeli sa\u011fl\u0131k sorunlar\u0131 ortaya \u00e7\u0131kar. <\/strong><\/span><\/span><\/p>\n

Yanl\u0131\u015f ila\u00e7 kullan\u0131m\u0131n\u0131n ekonomik boyutu<\/span><\/span><\/strong><\/p>\n

Re\u00e7eteli ve re\u00e7etesiz kullan\u0131lan ila\u00e7lar nedeniyle insanlar\u0131n g\u00f6rd\u00fc\u011f\u00fc zararlar\u0131n tedavisi, tedavi maliyetlerini artt\u0131r\u0131r.<\/span><\/p>\n

Hastaneye ba\u015fvuru oran\u0131 ve kal\u0131\u015f s\u00fcresindeki uzama sa\u011fl\u0131k bak\u0131m sistemleri \u00fczerine b\u00fcy\u00fck \u00e7apl\u0131 ekonomik y\u00fck getirir.<\/span><\/p>\n

Advers etkilerin tedavisi i\u00e7in sa\u011fl\u0131k harcamalar\u0131n\u0131n baz\u0131 \u00fclkelerde %15 ile %20\u2019ye ula\u015ft\u0131\u011f\u0131 g\u00f6r\u00fclmektedir. (B.Carelton, Mart 2005 (CPSP)<\/span><\/p>\n

Amerika\u2019da ;<\/span><\/span><\/strong><\/p>\n

Advers etki harcamalar\u0131 30-130 milyar $\/y\u0131l<\/span><\/span><\/strong><\/p>\n

\u2022<\/span>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span>Diabet 45 milyar$<\/span><\/span><\/p>\n

\u2022<\/span>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span>Obesite 70 milyar$<\/span><\/span><\/p>\n

\u2022<\/span>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span>Kardiyovask\u00fcler 99 milyar$<\/span><\/span><\/p>\n

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

\u0130stenmeyen etkiler ciddi hasarlara ve hatta \u00f6l\u00fcmlere neden olabilir.<\/span><\/span><\/strong><\/p>\n

\u0130la\u00e7lara ba\u011fl\u0131 zehirlenme ve intihar riski giderek artmaktad\u0131r.<\/span><\/p>\n

ABD\u2019de her y\u0131l ila\u00e7lara ba\u011fl\u0131 yan etkiler nedeniyle 1.5 milyon ki\u015fi hastaneye yat\u0131yor ve y\u0131lda 100 bin ki\u015fi \u00f6l\u00fcyor.(Lazarou&Pomeranz,1998) <\/span><\/p>\n

ABD\u2019de 1 y\u0131lda (2002); 2.1 milyon advers etki<\/strong>, 100 bin hasta \u00f6l\u00fcm\u00fc<\/strong>, 1 milyon hastane vakas\u0131 <\/strong>rapor edilmi\u015ftir. Studies of Drug Ultilization, 2002\u00a0 <\/span>David Lee,MD, Ulf Bergman Md,PHD)<\/span><\/p>\n

ABD\u2019de NSAI ila\u00e7lar\u0131n gastrointestinal yan etkisine ba\u011fl\u0131, en konservatif bir tahminle, y\u0131lda 7500 \u00f6l\u00fcm g\u00f6r\u00fclmektedir. <\/span><\/p>\n

ABD\u2019de hastaye ba\u015fvuran pediatrik vakalar\u0131n % 13-16\u2019s\u0131 advers etkiler ve bunlar\u0131n \u00a0<\/span>% 27.9\u2019u ciddi advers etkiler nedeniyledir. (Studies of Drug Ultilization, 2002 \u00a0<\/span>Chapter Authors:David Lee,MD, Ulf Bergman Md,PHD)<\/span><\/p>\n

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

\u00d6l\u00fcmle sonu\u00e7lanan en \u00e7ok raporlanan \u015f\u00fcpheli ila\u00e7lar. <\/span><\/span><\/strong><\/p>\n

(Arch \u0131ntern Med. 2007; 167(16) :1752-1759)<\/span><\/p>\n

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

1.Oxycodone \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>opioid analjezik<\/span><\/p>\n

2.Fentanyl\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>opioid analjezik<\/span><\/p>\n

3.Clozapine\u00a0 <\/span>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>Antipisikotik<\/span><\/p>\n

4.Morphine\u00a0\u00a0 <\/span>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>opioid analjezik<\/span><\/p>\n

5.Acetaminophen \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>analjezik<\/span><\/p>\n

6.Methadone \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>opioid analjezik\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span><\/p>\n

7.Infliximab\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>otoimmun hastal\u0131k<\/span><\/p>\n

8.Interferon beta\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>immunomodulat\u00f6r<\/span><\/p>\n

9.Risperidone \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>Antipsikotik<\/span><\/p>\n

10.Etanercept \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>otoimmun hastal\u0131k<\/span><\/p>\n

11.Paclitaxel\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>antineoplastik<\/span><\/p>\n

12.Acetaminophen-hdrocodone\u00a0 <\/span>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>analjezik kombinasyonu<\/span><\/p>\n

13.Olanzapine\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>antineoplastik<\/span><\/p>\n

14.Rofecocxib\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>NSAID<\/span><\/p>\n

15.Paroxetine \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span>antidepresan <\/span><\/p>\n

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

En \u00e7ok raporlanan 15 ila\u00e7 i\u00e7inde 7 tanesi a\u011fr\u0131 kesicidir<\/span><\/span><\/p>\n

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

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

Devletin g\u00f6revi toplum sa\u011fl\u0131\u011f\u0131n\u0131 korumak ve herkese sa\u011fl\u0131kl\u0131 bir ya\u015fam sa\u011flamakt\u0131r.<\/span><\/p>\n

Sa\u011fl\u0131k hizmeti, sadece al\u0131n\u0131p sat\u0131lan ve i\u015fletmelerin kar edip, h\u00fck\u00fcmetlerin tasarruf yapt\u0131\u011f\u0131 bir pazar de\u011fildir.<\/span><\/p>\n

Sa\u011fl\u0131k hizmeti her bireye kay\u0131ts\u0131z \u015farts\u0131z, e\u015fit, paras\u0131z ve nitelikli bi\u00e7imde sunulmal\u0131d\u0131r. Nitelikli sa\u011fl\u0131k hizmeti sadece nitelikli sa\u011fl\u0131k personeli ile verilir.<\/span><\/p>\n

Eczac\u0131s\u0131z veya eczane d\u0131\u015f\u0131nda ila\u00e7 sat\u0131\u015f\u0131 d\u00fc\u015f\u00fcn\u00fclemez.<\/span><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

\u0130LA\u00c7, s\u0131radan bir t\u00fcketim maddesi de\u011fil, temel bir sa\u011fl\u0131k \u00fcr\u00fcnd\u00fcr. \u0130la\u00e7 kullan\u0131m\u0131 uzmanl\u0131k konusudur. \u0130lac\u0131n se\u00e7imi t\u00fcketicinin tercihi ile de\u011fil...<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[58],"tags":[],"class_list":["post-3945","post","type-post","status-publish","format-standard","hentry","category-ecz-nurdan-demirkan"],"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\/3945","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\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3945"}],"version-history":[{"count":1,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=\/wp\/v2\/posts\/3945\/revisions"}],"predecessor-version":[{"id":3961,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=\/wp\/v2\/posts\/3945\/revisions\/3961"}],"wp:attachment":[{"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3945"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3945"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3945"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}