Non-Steroid Anti-İnflmatuvar ilaç kullanımına bağlı multiorgan yetmezliği: Olgu sunumu / Multiorgan failure due to Non-Steroidal Anti-Inflammatory drug use: A case report
Yükleniyor...
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
T.C. Maltepe Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu olgu sunumunda acil servise bilinç bulanıklığı ile başvuran, non-steroid anti-inflamatuar ilaç kullanımına bağlı multiorgan yetmezliği gelişen hastayı sunmayı amaçladık. Acil servise 32 yaşında erkek hasta uykuya meyil ve bilinç bulanıklığı şikâyeti ile getirildi. Bilinen kronik herhangi bir hastalığının olmadığı, alkol kullanım ve madde bağımlılığı hikayesinin olmadığı söylendi. Hasta yakınlarından alınan anamnezde son 1 yıldır diş ağrıları için düzensiz ve kontrolsüz şekilde naproksen + kodein (550 mg / 30 mg) içeren tablet ilaç kullandığı öğrenildi. Genelde günde 1-4 tablet arasında kullanmak üzere, en son acil servisimize başvurduğu gün 3 tablet kullandığı öğrenildi. Yapılan fizik muayenesinde genel durumu orta, bilinci açık, uykuya meyilli ve letarjik, konuşma bozukluğu, terleme, pupillerinde bilateral miyozis saptandı. Oda havasında oksijen saturasyonu (SaO2) 89’lara kadar düşüp nazal oksijen desteği ile SaO2 >96 olması dışındaki vitalleri stabildi. Bakılan laboratuvar sonuçlarında 10 katı geçen transaminaz yüksekliği ve protrombin zamanında uzama saptanan hasta, akut karaciğer yetmezliği ön tanısı ile hastanenin yoğun bakım ünitesinde tedavi ve takibine devam edildi. Acil servise bilinç bulanıklığı ile hastaneye başvuran, herhangi bir komorbid hastalığı olmayan ve özellikle genç hastalarda ilaç kullanımının sorgulanması unutulmamalıdır. Karaciğer yetmezliği tespit edilen bu hastalarda, nakil yapılabilecek durumların gözden kaçmaması gerekir. Transplantasyon endikasyonu olması durumunda, organ nakillerinin yapıldığı merkezlerde tedavi ve takipleri yapılmalıdır.
In this case report, we aimed to present a patient who presented to the emergency department with confusion and developed multiorgan failure due to the use of non-steroidal anti-inflammatory drugs. A 32-year-old male patient was brought to the emergency department with complaints of drowsiness and confusion. It was said that he did not have any known chronic disease and had no history of alcohol use or substance abuse. In the anamnesis taken from the relatives of the patient, it was learned that he had been using tablets containing naproxen + codeine (550 mg / 30 mg) irregularly and uncontrollably for the last 1 year for toothache. It was learned that he used 3 tablets on the last day he applied to our- emergency service, generally between 1-4 tablets per day. On physical examination, her general condition was moderate, she was conscious, sleepy and lethargic, speech disorder, sweating, and bilateral miosis in her pupils were found. Her vitals were stable, except that the oxygen saturation (SaO2) in room air decreased to 89 and SaO2 was> 96 with nasal oxygen support. In the laboratory results, the transaminase elevation exceeding 10 times and prothrombin time prolongation were detected. The patient was treated and followed up in the intensive care unit of the hospital with a preliminary diagnosis of acute liver failure.The patient was treated and followed up in the intensive care unit of the hospital with a preliminary diagnosis of acute liver failure. It should not be forgotten that the use of drugs should be questioned in patients who apply to the emergency department with clouding of consciousness, do not have any comorbid diseases, and especially in young patients. In these patients with hepatic insufficiency, the situations in which transplantation can be performed should not be overlooked. In case of transplantation indication, treatment and follow-up should be done in centers where organ transplantation is performed.
In this case report, we aimed to present a patient who presented to the emergency department with confusion and developed multiorgan failure due to the use of non-steroidal anti-inflammatory drugs. A 32-year-old male patient was brought to the emergency department with complaints of drowsiness and confusion. It was said that he did not have any known chronic disease and had no history of alcohol use or substance abuse. In the anamnesis taken from the relatives of the patient, it was learned that he had been using tablets containing naproxen + codeine (550 mg / 30 mg) irregularly and uncontrollably for the last 1 year for toothache. It was learned that he used 3 tablets on the last day he applied to our- emergency service, generally between 1-4 tablets per day. On physical examination, her general condition was moderate, she was conscious, sleepy and lethargic, speech disorder, sweating, and bilateral miosis in her pupils were found. Her vitals were stable, except that the oxygen saturation (SaO2) in room air decreased to 89 and SaO2 was> 96 with nasal oxygen support. In the laboratory results, the transaminase elevation exceeding 10 times and prothrombin time prolongation were detected. The patient was treated and followed up in the intensive care unit of the hospital with a preliminary diagnosis of acute liver failure.The patient was treated and followed up in the intensive care unit of the hospital with a preliminary diagnosis of acute liver failure. It should not be forgotten that the use of drugs should be questioned in patients who apply to the emergency department with clouding of consciousness, do not have any comorbid diseases, and especially in young patients. In these patients with hepatic insufficiency, the situations in which transplantation can be performed should not be overlooked. In case of transplantation indication, treatment and follow-up should be done in centers where organ transplantation is performed.
Açıklama
Anahtar Kelimeler
Acil Servis, Tiamin Eksikliği, Wernicke Ensefalopatisi, Naproxen and Codeine, Hepatotoxicity, Multiorgan Failure, Liver Transplantation
Kaynak
Maltepe Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
15
Sayı
2
Künye
Mamiş, M. S. ve Uyanıkoğlu, A. (2023). Non-Steroid Anti-İnflmatuvar ilaç kullanımına bağlı multiorgan yetmezliği: Olgu sunumu / Multiorgan failure due to Non-Steroidal Anti-Inflammatory drug use: A case report, Maltepe Tıp Dergisi, T.C. Maltepe Üniversitesi, 15(2), s.63-66.
