ULOGA FARMAKOGENETIKE U NEŽELJENIM DEJSTVIMA ANTEPILEPTIČNE TERAPIJE KOD DECE - KADA PEDIJATAR MORA BITI NA OPREZU?
Ključne reči:
deca, epilepsija, farmakogenetika, neželjena dejstva lekovaApstrakt
Poznato je da antiepileptična terapija može dovesti do ispoljavanja brojnih neželjenih dejstava, zbog čega je potreban redovan monitoring od strane lekara, psihologa, ali i edukacija porodice. Pažnja moderne epileptologije se u poslednje vreme poklanja i farmakogenetici, obzirom da pedijatrijski pacijenti imaju veći stepen farmakokinetske varijabilnosti i nepredvidljivosti dejstva antiepileptične terapije od odraslih.Upravo je cilj ovog rada bilo donošenje zaključka o odnosu farmakogenetike i farmakokinetike najčešče koriščenih antiepileptika kod dece (valproat, karbamazepin, levetiracetam, lamotrigin, etosuksimid), analizom i prikazom revijalnih radova i dostupne literature, kako bi se uvrstila u redovan rad pedijatra i trijaža pacijenata sa epilepsijom kod kojih se ispoljavaju neželjena dejstva, kod kojih ne dolazi do postizanja očekivanih koncentracija leka u serumu i efekata antiepileptične terapije, i pored pravilnog uzimanja leka, radi daljeg upućivanja na farmakogenteska ispitivanja uz saradnju sa neuropedijatrom, genetičaerm i metabologom. Obzirom da je zaključak istraživanja da postoje dokazi da farmakogenetika u vezi sa najčešće korišćenim antiepilepticima kod dece može imati uticaja na efekat terapije, pedijatar na primarnom nivou zdravstvene zaštite je od ključnog značaja, obzirom da upravo on, na redovnim pedijatrijskim kontrolama, može prvi uočiti potencijalna neželjena dejstva.
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