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Dergiler / Doğu Karadeniz Sağlık Bilimleri Dergisi / 2026 / Cilt: 4 Sayı: 2

Polifarması Sonucu Gelişen Multisistemik Yan Etkiler: 86 Yaşındaki Bir Erkekte Karmaşık Klinik Tablo

MULTISYSTEMIC ADVERSE EFFECTS DUE TO POLYPHARMACY: A COMPLEX CLINICAL PRESENTATION IN AN 86-YEAR-OLD MALE

Satuk Buğra Han Bozatlı(TRAKYA ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ACİL TIP ANABİLİM DALI)0000-0002-7695-9969
Eray Çeliktürk(TRAKYA ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ACİL TIP ANABİLİM DALI)0000-0002-1183-6511
Mustafa Burak Sayhan(TRAKYA ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ACİL TIP ANABİLİM DALI)0000-0001-9335-9001
Sayfa
232–246
Yayın Tarihi
2025-07-31
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

İlaç kullanımının optimizasyonu, hasta ve aile eğitimi ile bu riskler azaltılabilir.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Amaç: Polifarmasi, özellikle yaşlılarda, ilaç etkileşimlerine bağlı toksik sendrom riskini artırır.
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Temel Bulgular & Veri:Olgu: 86 yaşında, polifarmasi öyküsü olan erkek hasta, bilinç değişikliği ve uykuya meyil şikayetleriyle başvurdu.
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Sonuç & Katkı:İlaç kullanımının optimizasyonu, hasta ve aile eğitimi ile bu riskler azaltılabilir.
🔬Tür:Laboratuvar & Saha Deneyi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Antikolinerjik sendrom · Nöroleptik malign sendrom · Polifarmasi

Özet

Amaç: Polifarmasi, özellikle yaşlılarda, ilaç etkileşimlerine bağlı toksik sendrom riskini artırır. Bu olgu sunumu, polifarmasiye bağlı birden fazla toksik sendromun özelliklerini eş zamanlı gösteren bir vaka ve tanısal zorlukları vurgulamayı amaçlamaktadır. Olgu: 86 yaşında, polifarmasi öyküsü olan erkek hasta, bilinç değişikliği ve uykuya meyil şikayetleriyle başvurdu. Nörolojik muayenesinde artmış kas tonusu, kasılma nöbetleri ve hiperrefleksi saptandı. Laboratuvar ve görüntüleme tetkiklerinde enfeksiyöz, metabolik veya serebrovasküler patolojiye rastlanmadı. Klinik tablo, antikolinerjik sendrom, serotonin sendromu ve nöroleptik malign sendromun bir kombinasyonunu düşündürdü. Hastanın kullandığı ilaçlar gözden geçirilerek, potansiyel toksik etkileri değerlendirildi. Destekleyici tedavi ile hasta yoğun bakımda takip edildi ve dördüncü gün sonunda taburcu edildi. Sonuç: Polifarmasiye bağlı çoklu toksik sendromlar, yaşlı hastalarda tanı ve tedaviyi zorlaştırabilir. Bu tür vakalarda, hastanın kullandığı ilaçların detaylı analizi, toksik sendromların erken tanınması ve multidisipliner yaklaşım kritik öneme sahiptir. İlaç kullanımının optimizasyonu, hasta ve aile eğitimi ile bu riskler azaltılabilir.

Abstract

Objective: Polypharmacy, particularly in the elderly, increases the risk of toxic syndromes due to drug interactions. This case report aims to emphasize the diagnostic challenges and the simultaneous presentation of multiple toxic syndromes associated with polypharmacy. Case Report: An 86-year-old male with a history of polypharmacy presented with altered consciousness and drowsiness. Neurological examination revealed increased muscle tone, seizure episodes, and hyperreflexia. Laboratory and imaging studies ruled out infectious, metabolic, or cerebrovascular pathologies. The clinical presentation suggested a combination of anticholinergic syndrome, serotonin syndrome, and neuroleptic malignant syndrome. A thorough review of the patient's medications was conducted to assess potential toxic effects. The patient was monitored in the intensive care unit and managed with supportive treatment. He was discharged on the fourth day. Conclusion: Multiple toxic syndromes due to polypharmacy can complicate diagnosis and treatment, particularly in elderly patients. In such cases, a detailed analysis of the patient’s medication, early recognition of toxic syndromes, and a multidisciplinary approach are crucial. Optimizing drug regimens and educating patients and their families can help mitigate these risks.

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Bu Makaleye Atıf Yap

Bozatlı, S. B. H., Çeliktürk, E., Sayhan, M. B. (2025). Polifarması Sonucu Gelişen Multisistemik Yan Etkiler: 86 Yaşındaki Bir Erkekte Karmaşık Klinik Tablo. Doğu Karadeniz Sağlık Bilimleri Dergisi, Cilt: 4 Sayı: 2, 232–246. https://doi.org/10.59312/ebshealth.1616416

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