tag:blogger.com,1999:blog-88492878307391895802024-03-13T09:05:32.577-07:00Pediatrik GüncellerUzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.comBlogger339125tag:blogger.com,1999:blog-8849287830739189580.post-49086896195404572892021-11-01T00:18:00.005-07:002021-11-01T00:47:27.634-07:00Anafilaksiye Genel Bir Bakış<p> </p><div class="WordSection1">
<p class="MsoNormal" style="line-height: 330%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 275.95pt; margin-right: 94.1pt; margin-top: 0cm; text-indent: -201.85pt;"><span style="color: #6fa8dc; font-family: Lucida Calligraphy; font-size: large;"><i>Anafilaksiye Genel Bir Bakış</i></span></p><p class="MsoNormal" style="line-height: 330%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 275.95pt; margin-right: 94.1pt; margin-top: 0cm; text-indent: -201.85pt;"><i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="color: #7f7f7f; font-family: "Lucida Calligraphy"; line-height: 330%;"><span style="font-size: x-large;">Dr.NevinKURT</span><span style="font-size: 42pt;"> </span></span></i><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-left: -.25pt;"><span lang="EN-US">Anafilaksi<o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-bottom: 50.05pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l22 level1 lfo1; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 24.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 30.0pt; line-height: 103%; mso-bidi-font-size: 11.0pt;">Alerjinin, tedavi edilmezse ölümle
sonuçlanabilen en ciddi klinik tablosudur.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 49.6pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l22 level1 lfo1; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 24.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 30.0pt; line-height: 103%; mso-bidi-font-size: 11.0pt;">Hızlı tanı konup, hızlı ve etkili
tedavi edilirse yaşam kurtarıcı acillerdendir.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 88.9pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l22 level1 lfo1; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 24.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 30.0pt; line-height: 103%; mso-bidi-font-size: 11.0pt;">Anafilaksiyi her hekimin iyi
bilmesi ve erken tanıyıp, erken müdahale etmesi gerekir</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">*</span><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">Pediatrics 2017; 139: e20164006.</span><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-bottom: 42.05pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">TANIM<o:p></o:p></span></h1>
<p class="MsoNormal" style="line-height: 108%; margin-bottom: 201.0pt; margin-left: 35.4pt; margin-right: 196.35pt; margin-top: 0cm; text-indent: -27.5pt;"><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 108%; mso-bidi-font-family: "Wingdings 3"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Wingdings 3";">u </span><span lang="EN-US" style="font-size: 26.0pt; line-height: 108%; mso-bidi-font-size: 11.0pt;">Anafilaksi, mast hücre ve
bazofillerden ani mediyatör salınımı sonucu gelişen, farklı klinik ve şiddette
olan, hızlı başlangıçlı, yaşamı tehdit eden, sistemik bir aşırı duyarlılık
reaksiyonudur.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: 8.4pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-size: 26.0pt; line-height: 104%; mso-bidi-font-size: 11.0pt;">* </span><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">J Allergy Clin Immunol 2011;127:587-93</span><i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-family: "Lucida Calligraphy"; font-size: 26.0pt; line-height: 104%; mso-bidi-font-family: "Lucida Calligraphy"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Lucida Calligraphy";">.</span></i><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-left: -.25pt;"><span lang="EN-US">ETYOLOJİ- EPİDEMİYOLOJİ<o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-bottom: 53.9pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l30 level1 lfo2; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Anafilaksinin gerçek sıklığı
bilinmemekle birlikte toplumda yaşam boyu prevalansının % 0.05 - % 2 olduğu
tahmin edilmektedir<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 100.7pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l30 level1 lfo2; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Çocuklardaki görülme sıklığı
ise daha yüksektir. Bir çalışmada çocuklarda bu sıklık %1.5 olarak
belirtilmiştir <o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 135%; margin-bottom: .8pt; margin-left: -.25pt; margin-right: 352.8pt; margin-top: 0cm;"><br /></p>
<h1 style="margin-bottom: 8.85pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">ANAFİLAKSİ NEDENLERİ <o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-bottom: 10.3pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l31 level1 lfo3; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 24.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 30.0pt; line-height: 103%; mso-bidi-font-size: 11.0pt;">BESİNLER: En sık neden (%33-56
).<span style="mso-spacerun: yes;"> </span><u style="text-underline: #404040;">Yer
fıstığı, Fındık</u>, Deniz Ürünleri, Yumurta, Susam.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.3pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l31 level1 lfo3; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 24.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 30.0pt; line-height: 103%; mso-bidi-font-size: 11.0pt;">İLAÇLAR : Erişkinde en sık neden .
Beta lactam antibiyotikler, NSAİ.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.3pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l31 level1 lfo3; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 24.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 30.0pt; line-height: 103%; mso-bidi-font-size: 11.0pt;">VENOM: Arı ve karınca .</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.3pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l31 level1 lfo3; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 24.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 30.0pt; line-height: 103%; mso-bidi-font-size: 11.0pt;">LATEKS: Sağlık çalışanlarının %12
sinde. </span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.3pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l31 level1 lfo3; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 24.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 30.0pt; line-height: 103%; mso-bidi-font-size: 11.0pt;">AŞILAR: İçeriğindeki jelatin ve
yumurta.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.3pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l31 level1 lfo3; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 24.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 30.0pt; line-height: 103%; mso-bidi-font-size: 11.0pt;">EGZERSİZ: Büyük yaşta erkek
çocuklarda.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 60.2pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l31 level1 lfo3; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 24.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 30.0pt; line-height: 103%; mso-bidi-font-size: 11.0pt;">İDİYOPATİK: Erkeklerde sık. Yaşla artar.
Mastositoz dışlanmalıdır. </span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: 7.2pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-size: 30.0pt; line-height: 104%; mso-bidi-font-size: 11.0pt;">*</span><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">Çocuk Dergisi ,2011;11(2):43-53</span><span lang="EN-US"><o:p></o:p></span></p>
</div>
<span lang="EN-US" style="color: #404040; font-family: "Calibri",sans-serif; font-size: 28.0pt; line-height: 103%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span>
<div class="WordSection2">
<p class="MsoNormal" style="margin-bottom: 10.35pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l31 level1 lfo3; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 24.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Anafilaksi klasik olarak IgE
aracılığıyla mast hücre ve bazofillerin degranüle olması sonucu mediyatörlerin
açığa çıkması aracılığıyla oluşur. <o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 101%; margin-bottom: 10.8pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l31 level1 lfo3; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 24.0pt; line-height: 101%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Bu mediyatörler histamin,
heparin, triptaz, kimaz, karboksipeptidaz A3, tümör nekrozis faktör a (TNF-a),
katepsin G gibi <b style="mso-bidi-font-weight: normal;">önceden sentezlenmiş </b>mediyatörler
ve <o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 56.45pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l31 level1 lfo3; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 24.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">platalet aktive edici faktör
(PAF), prostaglandin (PG) D2, lökotrien (LT) C4, sitokinler (interlökin (IL)
-5, IL-6, IL-8, IL-13, IL-33, TNF-a ve granulosit makrofaj koloni stimülan
faktör (GM-CSF) ve kemokinler (MIP-1a, MIP-1b ve MCP1) gibi <b style="mso-bidi-font-weight: normal;">yeni sentezlenen </b>mediyatörler olmak
üzere iki gruptur.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">*</span><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">Allergy 2011;66(1):1-14</span><span lang="EN-US">.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 107%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 152.45pt; margin-right: 0cm; margin-top: 0cm; text-indent: 0cm;"><br /></p>
<p class="MsoNormal" style="margin-bottom: 10.35pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l31 level1 lfo3; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 24.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Nadiren mast hücreleri ve
bazofiller, IgE aracılığı olmadan immunolojik olarak uyarılabilirler<b style="mso-bidi-font-weight: normal;">. IgG aracılıklı </b>anafilaksi yüksek
molekül ağırlıklı demir dekstran ve infliksimaba bağlı olarak bildirilmiştir<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.55pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l31 level1 lfo3; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 24.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Anafilaksi <b style="mso-bidi-font-weight: normal;">immunolojik olmayan </b>mekanizmalarla da gelişebilir. Egzersiz, soğuk,
sıcak, güneş ışını/UV radyasyon gibi fiziksel faktörler, etanol ve opiyatlar
gibi ilaçlar direkt mast hücre degranülasyonu yaparak anafilaksiye neden
olabilirler.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 56.65pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l31 level1 lfo3; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 24.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">İDİYOPATİK : Bir neden
bulunamaz.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">*</span><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">Clin Exp Allergy. 2019;49(7):942-952.</span><span lang="EN-US"><o:p></o:p></span></p>
</div>
<span lang="EN-US" style="color: #404040; font-family: "Calibri",sans-serif; font-size: 28.0pt; line-height: 103%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span>
<div class="WordSection3">
<h1 style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">KLİNİK<o:p></o:p></span></h1>
<p class="MsoNormal" style="line-height: 92%; margin-bottom: 10.7pt; margin-left: 27.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l10 level1 lfo4; text-indent: -27.5pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 19.0pt; line-height: 92%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 24.0pt; line-height: 92%; mso-bidi-font-size: 11.0pt;">Anafilaksi en sık 5 organ sisteminde
bulgulara yol açar. Bunlar sıklıklarına göre; cilt, mukoza, solunum,
kardiyovasküler, gastrointestinal sistem ve nörolojik sistemdir. </span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 92%; margin-bottom: 9.1pt; margin-left: 27.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l10 level1 lfo4; text-indent: -27.5pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 19.0pt; line-height: 92%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 24.0pt; line-height: 92%; mso-bidi-font-size: 11.0pt;">Bulgular parenteral yolla alımı
takiben 5-30 dk.’da ortaya çıkar, bazen 1 saat ve üzerindeki sürede de ortaya
çıkabilir. </span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 92%; margin-bottom: 8.2pt; margin-left: 27.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l10 level1 lfo4; text-indent: -27.5pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 19.0pt; line-height: 92%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 24.0pt; line-height: 92%; mso-bidi-font-size: 11.0pt;">Oral yolla alımdan sonra genellikle
ilk 2 saatte oluşur. Birkaç saate kadar gecikebilir.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 92%; margin-bottom: 10.7pt; margin-left: 27.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l10 level1 lfo4; text-indent: -27.5pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 19.0pt; line-height: 92%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 24.0pt; line-height: 92%; mso-bidi-font-size: 11.0pt;">Reaksiyon ne kadar hızlı ortaya
çıkarsa, anafilaksinin şiddeti de o kadar fazladır. Erken başlayan
reaksiyonlarda ölüm riski daha yüksektir. Başlangıç semptomları iç sıkıntısı,
ölüm korkusu, baş dönmesi ve bayılma hissi şeklindedir </span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 93%; margin-bottom: 47.75pt; margin-left: 27.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l10 level1 lfo4; text-indent: -27.5pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 19.0pt; line-height: 93%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-size: 24.0pt; line-height: 93%; mso-bidi-font-size: 11.0pt;">Anafilaktik
bir reaksiyonun başlangıcında, hafif kaşıntı veya avuç içi ve ayak tabanlarında
veya anogenital bölgede yanma hissi, metalik tat, anksiyete, baş ağrısı ve
yönelim bozukluğu ile "<b style="mso-bidi-font-weight: normal;">prodromal
semptomlar</b>" şeklinde semptomlar görülebilir.</span></i><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-size: 24.0pt; line-height: 104%; mso-bidi-font-size: 11.0pt;">* </span><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">J Allergy Clin Immunol 2010;125(2 Suppl 2):161-81.</span><span lang="EN-US"><o:p></o:p></span></p>
<h2 style="margin-bottom: 16.55pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">Cilt -mukoza (%80-90)<o:p></o:p></span></h2>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l12 level1 lfo5; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="EN-US">Ürtiker</span></i></b><span lang="EN-US">, anjioödem, morbiliform döküntü<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.1pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l12 level1 lfo5; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Kaşıntı, karıncalanma, sıcak
basması, flushing,<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.1pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l12 level1 lfo5; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Periorbital kaşıntı, şişlik,
eritem, konjunktival kaşıntı, akıntı<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.2pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l12 level1 lfo5; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Dudak, dil, uvula ve yumuşak
damakta kaşıntı ve şişlik<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l12 level1 lfo5; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Dış kulak yolu, avuç içi, ayak
tabanı ve genital bölgede kaşıntı<o:p></o:p></span></p>
<h2 style="margin-left: -.25pt;"><span lang="EN-US">Solunum Sistemi (%40-70)<o:p></o:p></span></h2>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l11 level1 lfo6; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Burun: Akıntı, tıkanıklık,
kaşıntı, hapşırık<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l11 level1 lfo6; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Larinks: Ses kısıklığı, boğulma
hissi, stridor, disfoni, disfaji,<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l11 level1 lfo6; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Akciğer: Nefes darlığı, vizing,
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">bronkospazm</i></b>,
solunum yetmezliği, öksürük, göğüste sıkışma hissi<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l11 level1 lfo6; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Siyanoz<br clear="all" style="mso-special-character: line-break; page-break-before: always;" />
<o:p></o:p></span></p>
<h2 style="margin-left: -.25pt;"><span lang="EN-US">Kardiyovasküler Sistem (%10-45)<o:p></o:p></span></h2>
<p class="MsoNormal" style="line-height: 107%; margin-bottom: 7.35pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l24 level1 lfo7; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 107%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="EN-US">Hipotansiyon,</span></i></b><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l24 level1 lfo7; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Taşikardi, bradikardi, disritmi<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l24 level1 lfo7; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Göğüs ağrısı, çarpıntı<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l24 level1 lfo7; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Şok, senkop<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l24 level1 lfo7; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Aritmi,<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l24 level1 lfo7; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Kardiyak arrest<o:p></o:p></span></p>
<h2 style="margin-left: -.25pt;"><span lang="EN-US">Gastrointestinal Sistem(%30-45)<o:p></o:p></span></h2>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l16 level1 lfo8; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Bulantı-kusma<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l16 level1 lfo8; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Karın ağrısı-kramp<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l16 level1 lfo8; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">ishal<br clear="all" style="mso-special-character: line-break; page-break-before: always;" />
<o:p></o:p></span></p>
<h2 style="margin-left: -.25pt;"><span lang="EN-US">Nörolojik Sistem (%10-15)<o:p></o:p></span></h2>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l23 level1 lfo9; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Ölüm korkusu, huzursuzluk<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l23 level1 lfo9; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Bilinç değişiklikleri,
konvülsiyon<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l23 level1 lfo9; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Konfüzyon<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l23 level1 lfo9; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Baş ağrısı, bulanık görme<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l23 level1 lfo9; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Ani davranış değişiklikleri<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 133%; margin-left: 27.0pt; mso-list: l23 level1 lfo9; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 133%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span lang="EN-US">Huzursuzluk (süt çocuğu ve küçük çocuklarda ani davranış
değişikliği, örneğin: irritabilite, oyunu bırakma, anneye yapışma )<o:p></o:p></span></p>
<h2 style="margin-left: -.25pt;"><span lang="EN-US">Diğer<o:p></o:p></span></h2>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l13 level1 lfo10; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Terleme, inkontinans<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.35pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l13 level1 lfo10; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Ağızda metalik tat, disfaji<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l13 level1 lfo10; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Uterus kontraksiyonları<br clear="all" style="mso-special-character: line-break; page-break-before: always;" />
<o:p></o:p></span></p>
<h1 style="margin-left: -.25pt;"><span lang="EN-US">TANI<o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-left: 33.35pt; mso-list: l5 level1 lfo11; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span lang="EN-US">Anafilaksinin tanısı esas olarak <b style="mso-bidi-font-weight: normal;">klinik bulgularla </b>konur.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 33.35pt; mso-list: l5 level1 lfo11; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span lang="EN-US">Anafilaksi kliniği ile gelen hastada hızlıca ayrıntılı öykü
alınmalıdır. <o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 33.35pt; mso-list: l5 level1 lfo11; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span lang="EN-US">Ancak öykü alınırken tedavide gecikmeye neden olunmamalıdır.
Özellikle bulguların ortaya çıkmasından önce anafilaksi tetikleyicilerine maruz
kalıp kalmadığı, benzer bulgulara yol açabilecek bir hastalığı olup olmadığı,<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 58.8pt; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l5 level1 lfo11; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Olaydan önceki 6 saat içinde
aldığı besinler ve ilaçlar, böcek ısırması, egzersiz, sıcak-soğuğa temasın olup
olmadığı sorulmalıdır. Eğer kadın ise mens dönemi ile ilişkisi sorulmalıdır.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">* </span><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">J Allergy Clin Immunol 2010;126(3):477-80.1-42.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 107%; margin-bottom: 13.45pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm; text-indent: 0cm;"><span lang="EN-US" style="color: #5fcbef; font-family: "Trebuchet MS",sans-serif; font-size: 32.0pt; line-height: 107%; mso-bidi-font-family: "Trebuchet MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Trebuchet MS";">Şu 3 kriterden herhangi biri varsa anafilaksi
tanısı konur :</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 108%; margin-bottom: 48.3pt; margin-left: -.75pt; margin-right: 0cm; margin-top: 0cm; text-indent: 23.5pt;"><span lang="EN-US" style="font-size: 26.0pt; line-height: 108%; mso-bidi-font-size: 11.0pt;">1) Ani
başlangıçlı (dakikalar veya saatler içinde gelişen) <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">cilt, mukoza veya her ikisinin
tutulumu </i></b>(yaygın ürtiker, kaşıntı veya flushing, dudak dil-uvulada
şişme)</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 108%; margin-bottom: 48.0pt; margin-left: 5.9pt; margin-right: 0cm; margin-top: 0cm; text-indent: 0cm;"><span lang="EN-US" style="font-size: 26.0pt; line-height: 108%; mso-bidi-font-size: 11.0pt;">ve ek
olarak aşağıdakilerden <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u style="text-underline: #404040;">en az bir tanesinin
</u></i></b><i style="mso-bidi-font-style: normal;">eşlik etmesi:</i></span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 108%; margin-bottom: 50.1pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l25 level1 lfo12; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 108%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 26.0pt; line-height: 108%; mso-bidi-font-size: 11.0pt;">a) <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">Solunum problemi </i></b>(dispne,
hışıltı, bronkospazm, stridor, PEF (peak ekspiratuvar flow-tepe ekspiryum akım
hızı)’de düşme, hipoksemi)</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 108%; margin-bottom: 3.9pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l25 level1 lfo12; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 108%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 26.0pt; line-height: 108%; mso-bidi-font-size: 11.0pt;">b<i style="mso-bidi-font-style: normal;">) <b style="mso-bidi-font-weight: normal;">Hipotansiyon </b></i>veya
hipotansiyona bağlı uç organ disfonksiyonunu gösteren bulgular (hipotoni, kollaps,
senkop, inkontinans)</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: -.75pt; text-indent: 19.1pt;"><span lang="EN-US">2) Hastanın muhtemel bir alerjen ile karşılaşmada dakikalar veya
saatler sonra aşağıdakilerden <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><u style="text-underline: #404040;">2 veya
daha fazlasının </u></i></b>gelişmesi:<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l25 level1 lfo12; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">a) Deri ve/veya mukoza tutulumu
(yaygın ürtiker, kaşıntı-flushing, dildudak-uvulada şişme)<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l25 level1 lfo12; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">b) Solunum sıkıntısı (dispne,
hışıltı, bronkospazm, stridor, PEF’ de düşme, hipoksemi)<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.7pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l25 level1 lfo12; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">c) Hipotansiyon veya ilişkili
semptomlar (hipotoni, kollaps, senkop, inkontinans)<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l25 level1 lfo12; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">d) Persistan gastrointestinal
semptomlar (kramp şeklinde karın ağrısı,kusma)<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 53.9pt; margin-left: -.75pt; margin-right: 0cm; margin-top: 0cm; text-indent: 25.45pt;"><span lang="EN-US">3) Hastanın daha önceden
bilinen alerjen ile karşılaşmada dakikalar veya saatler içinde <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">hipotansiyon
</i></b>gelişmesi:<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.25pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l25 level1 lfo12; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">a) Süt çocukları ve çocuklar
için: Yaşa göre düşük sistolik kan basıncı veya sistolik kan basıncında %30’dan
fazla düşüş<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l25 level1 lfo12; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">b) Yetişkinler için: Sistolik
kan basıncının 90 mmHg’dan düşük olması veya kişinin bazal sistolik kan
basıncından %30’dan fazla düşüş olması.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l25 level1 lfo12; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Hipotansiyon sınırları:<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 32.4pt;"><span lang="EN-US">1 ay -1 yaş
arasında <70 mmHg, <o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 127%; margin-bottom: 8.55pt; margin-left: 32.4pt; margin-right: 362.4pt; margin-top: 0cm;"><span lang="EN-US">1-10 yaş arasında:
70+(2xyaş) mmHg, 11-17 yaş arasında <90 mmHg.<o:p></o:p></span></p>
<h1 style="margin-left: -.25pt;"><span lang="EN-US">LABORATUVAR<o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-bottom: 10.2pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l17 level1 lfo13; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Anafilaksi tanısı klinik ile
konulmaktadır. <o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.4pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l17 level1 lfo13; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Ancak bazı hastalarda serum
histamin ve triptaz düzeyi gibi laboratuvar testleri kullanılabilir. Semptom
başlangıcından 15 dk-1 saat arasında alınan serum histamin düzeyi tanıda
yardımcı olabilir.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 45.25pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l17 level1 lfo13; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Semptom başlangıcından 15 dk -
3 saat arasında alınan serum triptaz seviyesi >11.4 mcg/L olması anafilaksi
tanısını destekler .Ancak normal olması tanıyı dışlamaz.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">*
J Allergy Clin Immunol 2011;127:587-93</span><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-bottom: 1.7pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">AYIRICI TANI<o:p></o:p></span></h1>
<p class="MsoNormal" style="line-height: 108%; margin-bottom: 5.5pt; margin-left: 27.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo14; text-indent: -27.5pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 108%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 26.0pt; line-height: 108%; mso-bidi-font-size: 11.0pt;">Anafilaksi ile en sık karışan
klinik tablo <b style="mso-bidi-font-weight: normal;">vazovagal senkop </b>atağıdır.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 108%; margin-bottom: 3.9pt; margin-left: 27.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo14; text-indent: -27.5pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 108%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 26.0pt; line-height: 108%; mso-bidi-font-size: 11.0pt;">Vazovagal senkopta hastalarda vagal
uyarı sonucu ani gelişen hipotansiyon vardır ve <b style="mso-bidi-font-weight: normal;">bradikardi g</b>örülür (anaflakside genellikle taşikardi olur) .</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 108%; margin-bottom: 6.45pt; margin-left: 27.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo14; text-indent: -27.5pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 108%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 26.0pt; line-height: 108%; mso-bidi-font-size: 11.0pt;">Solukluk ve terleme eşlik eder ve
ürtiker gibi deri bulguları ile solunumsal semptomlar eşlik etmez.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 108%; margin-bottom: 84.25pt; margin-left: 27.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo14; text-indent: -27.5pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 108%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 26.0pt; line-height: 108%; mso-bidi-font-size: 11.0pt;">Anaflakside astım atağı, ürtiker,
panik atak, hiperventilasyon sendromu, şok gibi durumlar da ayırıcı tanıya
girmektedir.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-size: 26.0pt; line-height: 104%; mso-bidi-font-size: 11.0pt;">*</span><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">J Allergy Clin Immunol 2006;117:391-7.</span><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-bottom: 7.5pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">Klinik - literatür<o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-bottom: 10.7pt; margin-left: 27.0pt; margin-right: 21.25pt; margin-top: 0cm; mso-list: l15 level1 lfo15; text-align: justify; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Olabarri ve ark .
hipotansiyonun anafilaksi bulgusu olduğunu bilen hekim oranı % 69.7 olarak
bildirilmiştir.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 101%; margin-bottom: 9.1pt; margin-left: 27.0pt; margin-right: 21.25pt; margin-top: 0cm; mso-list: l15 level1 lfo15; text-align: justify; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 101%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span lang="EN-US">Paramediklerle yapılan bir çalışmada<span style="mso-spacerun: yes;">
</span>paramediklerin tipik anafilaksi semptomlarını %98.8 ni tanıdığını,
ancak<span style="mso-spacerun: yes;"> </span>atipik semptomları sadece %3’ünün
tanıyabildiği görülmüştür. <o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 101%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 27.0pt; margin-right: 21.25pt; margin-top: 0cm; mso-list: l15 level1 lfo15; text-align: justify; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 101%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Meksika'da hekimlerin
%97.4'ünün cilt, solunum ve kardiyak semptomları olan bir anafilaksi vakasını
doğru şekilde teşhis edebildiği, ancak cilt semptomları olmadan anafilaksi
teşhisi koyan hekim oranının %56.4 olduğunu bildirmiştir.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 90%; margin-bottom: 9.5pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 12.0pt; line-height: 90%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">*Olabarri
M, Gonzalez-Peris S, Vázquez P, González-Posada A, Sanz N, Vinuesa A, Diez N,
Benito J, Mintegi S. Management of anaphylaxis in Spain: pediatric emergency
care providers' knowledge. Eur J Emerg Med. 2019;26(3):163-167</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 90%; margin-bottom: 9.5pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 12.0pt; line-height: 90%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">**Jacobsen
RC, Toy S , Bonham AJ, Salomone JA, Ruthstrom J., Gratton M. Anaphylaxis
Knowledge Among Paramedics: Results of a National Survey, Prehospital Emergency
Care,2012, 16:4, 527-534,</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 90%; margin-bottom: 9.5pt; margin-left: -.75pt; margin-right: 0cm; margin-top: 0cm; text-indent: 5.3pt;"><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 12.0pt; line-height: 90%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">***</span></b><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 12.0pt; line-height: 90%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">Pimentel-Hayashi JA, Navarrete-Rodriguez EM, Moreno-Laflor OI,
Del Rio-Navarro BE. Physicians' knowledge regarding epinephrine underuse in
anaphylaxis. Asia Pac Allergy. 2020 , 22;10(4):e40. </span><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-left: -.25pt;"><span lang="EN-US">TEDAVİ<o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-bottom: 53.8pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l21 level1 lfo16; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Anafilaksi tedavisinde esas
olan erken tanı ve hızlı tedavidir.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 53.8pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l21 level1 lfo16; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Bu prognozu belirleyen en
önemli faktördür.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 88.65pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l21 level1 lfo16; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Anafilakside ADRENALİN,
uygulanması gereken ilk ilaçtır ve geciktirilmemelidir.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">*
Pediatr Emerg Care. 2008;24(12):861-6</span><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-bottom: 7.5pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">TEDAVİ- ADRENALİN :<span style="mso-spacerun: yes;">
</span>1/1 lik<o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-bottom: 10.7pt; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l14 level1 lfo17; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Adrenalin <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">intramüsküler </i></b>olarak (İM)
uyluk ön-yan tarafına (<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">vastus lateralis </i></b>kası)
uygulanmalıdır.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 33.35pt; mso-list: l14 level1 lfo17; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span lang="EN-US">İntramüsküler Adrenalin dozu 1/1 lik (<b style="mso-bidi-font-weight: normal;">1 mg/mL</b>) Adrenalinden <b style="mso-bidi-font-weight: normal;">0,01
mg/kg </b>dozunda (0.01 ml/kg) uygulanır.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.15pt; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l14 level1 lfo17; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Çocuklarda maksimum <b style="mso-bidi-font-weight: normal;">0,3 mg (3 dizyem)</b>; <o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.1pt; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l14 level1 lfo17; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Erişkinlerde <b style="mso-bidi-font-weight: normal;">0,5 mg (5 dizyem</b>) uygulanmalıdır. <o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: -.25pt;"><span lang="EN-US">( 10 kg: 1 dzy
;<span style="mso-spacerun: yes;"> </span>20 kg:2 dzy ; 30 kg ve sonras : 3 dzy)<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 51.8pt; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l14 level1 lfo17; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Gerektiğinde 5-10 dakikada bir
tekrarlanabilir <o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: -.25pt;"><span lang="EN-US">*
Allergy,2007;62(8):857-71<o:p></o:p></span></p>
<h1 style="margin-left: -.25pt;"><span lang="EN-US">Adrenalin - literatür<o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-bottom: 10.7pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l27 level1 lfo18; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Ülkemizde yakın tarihte yapılan
üç çalışma hekimlerin yarısının Adrenalin doğru dozunu bilmediğini ortaya
koydu.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 45.0pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l27 level1 lfo18; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Bu çalışmalarda Adrenalin
dozunu bilenlerin oranı %42.7, %57.5 ve %60 olarak bildirmiştir .<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: 2.6pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">*Tuncel
T, Sancakli O, Bag O, Cetin HS, Özdoğru EE. Physicians’ approach to anaphylaxis
in childhood. Pediatr Emerg Care 2020. doi: 10.1097/PEC</span><span lang="EN-US">.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 90%; margin-bottom: 9.1pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 90%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">**Arga
M, Topal E, Yılmaz S , Erdemli PC, Bıçakcı K, Bakırtaş A ,Knowledge Level on
Anaphylaxis and its Management, Turk J Pediatr 2021; 63(3): 372-383.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 90%; margin-bottom: 9.1pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 90%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">***Özkars
MY.,Anaflaksiye Aile Hekimlerinin Gözünden Bakış, Güncel Pediatri .
2019;17(1):3444 </span><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-left: -.25pt;"><span lang="EN-US">ADRENALİN<o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-bottom: 54.25pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l28 level1 lfo19; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Anafilaksi tedavisinde ilk
seçenek ilaç olan Adrenalin, ölüm ve hastaneye yatışı önleyen tek ilaçtır.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 52.15pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l28 level1 lfo19; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Anfilaksi ile başvuran
hastalarda Adrenalin uygulanması ile ilgili mutlak <b style="mso-bidi-font-weight: normal;">kontrendikasyon yoktur.</b><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 110%; margin-bottom: 54.45pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l28 level1 lfo19; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 110%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="EN-US">ŞÜPHELENİLDİĞİ ANDA
YAPILMALI !!</span></i></b><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">*</span><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">J. Allergy Clin Immunol 2011;127:587-93.</span><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-bottom: 6.8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">ADRENALİN <o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-bottom: 53.95pt; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l29 level1 lfo20; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Mukozal ödemi, membran
sızıntısını azaltır.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 53.85pt; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l29 level1 lfo20; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Bronkodilatasyon sağlar.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 91.75pt; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l29 level1 lfo20; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Vazodilatasyona bağlı
hipotansiyonu ve kollaps bulgularını düzeltir.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 107%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l29 level1 lfo20; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 107%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-size: 24.0pt; line-height: 107%; mso-bidi-font-size: 11.0pt;">1.
Basamak tedavisindeki ilk ve tek ilaçtır</span></i></b><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-left: -.25pt;"><span lang="EN-US">TEDAVİ<span style="mso-spacerun: yes;"> </span>2.basamak<o:p></o:p></span></h1>
<p class="MsoNormal" style="line-height: 107%; margin-bottom: 8.8pt; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l20 level1 lfo21; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 107%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">Hastaya uygun pozisyon vermek:</span></b><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 33.35pt; mso-list: l20 level1 lfo21; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span lang="EN-US">1-tetikleyici faktörleri uzaklaştırması; 2-Adrenalin uygulaması
sonrasında 3 . önerilen uygulamadır. <o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.35pt; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l20 level1 lfo21; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Eğer hasta solunum sıkıntısı
çekiyor ise oturur pozisyon verilmeli; dolaşım yetersizliği var ise yatar
pozisyona getirilip alt ekstremiteler yukarı kaldırılmalı ve böylece venöz
dolaşım arttırılmalıdır.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 33.35pt; mso-list: l20 level1 lfo21; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span lang="EN-US">Gebe ise sol yana yatırılmalıdır.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 44.85pt; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l20 level1 lfo21; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Hastalar aniden dik pozisyona
getirilmemelidir !!!<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">*
J Allergy Clin Immunol 2007;119:1018-9.</span><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-left: -.25pt;"><span lang="EN-US">TEDAVİ<span style="mso-spacerun: yes;"> </span>2.basamak<o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-bottom: 10.8pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l26 level1 lfo22; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Tüm hastalara yüz maskesi ile
yüksek akım oksijen tedavisi uygulanmalıdır :<b style="mso-bidi-font-weight: normal;">6-8 L/dk</b><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.25pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l26 level1 lfo22; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Damar yolu açılıp sıvı desteği,<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.2pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l26 level1 lfo22; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Vital bulgular stabilize
edilmeli,<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 53.65pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l26 level1 lfo22; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Solunum sıkıntısı varsa inhale
beta 2 agonist <o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 9.9pt; margin-left: 19.6pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">Sıvı Desteği :<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.0pt; margin-left: 19.6pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">Çocuklarda SF : 20 cc/kg<span style="mso-spacerun: yes;"> </span>bir saatte gidecek. ( gerekirse bolus)<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 19.6pt;"><span lang="EN-US">Erişkinde ilk 5
dakikada 10 cc/kg ; 1-2 L.<span style="mso-spacerun: yes;"> </span>bir saatte<o:p></o:p></span></p>
<h1 style="margin-left: -.25pt;"><span lang="EN-US">TEDAVİ 3. basamak<o:p></o:p></span></h1>
<p class="MsoNormal" style="line-height: 134%; margin-bottom: 43.4pt; margin-left: 27.0pt; margin-right: 137.6pt; margin-top: 0cm; mso-list: l0 level1 lfo23; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 134%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Üçüncü basamak tedavi H1 ve H2
antihistaminikleri </span><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 134%; mso-bidi-font-family: "Wingdings 3"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Wingdings 3";">u </span><span lang="EN-US">ve
glukokortikoidleri içermektedir.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 101%; margin-bottom: 96.6pt; margin-left: 27.0pt; margin-right: 137.6pt; margin-top: 0cm; mso-list: l0 level1 lfo23; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 101%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Sistemik antihistaminler
anafilaksi tedavisinde sıklıkla kullanılan ilaçlardır; ancak yalnızca kutanöz
semptomları azaltmak amacı ile kullanılması önerilmektedir.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: 13.2pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">*Allergy
; 2014;69(8):1026-45.</span><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-bottom: 7.4pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">TEDAVİ - Antihistaminik<o:p></o:p></span></h1>
<p class="MsoNormal" style="line-height: 107%; margin-bottom: 8.8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">H1 antihistaminik </span></b><span lang="EN-US">:<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.15pt; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l19 level1 lfo24; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Klorfeniramin 2,5-5 mg<span style="mso-tab-count: 1;"> </span>(Avil)<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 51.8pt; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l19 level1 lfo24; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">veya Difenhidramin 1 mg/kg,(
maks.50 mg)<span style="mso-spacerun: yes;"> </span>( Benadryl)<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 107%; margin-bottom: 8.8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">H2 antihistaminik</span></b><span lang="EN-US">:<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 53.8pt; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l19 level1 lfo24; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Ranitidine 1 mg/kg, ( maks.50
mg ) (Ulcuran)<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 56.45pt; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l19 level1 lfo24; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">H1 ve H2 antihistamin birlikte
kullanımı daha etkili olabilmektedir.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">*</span><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">Clin Allergy Immunol. 2002;17:287-317.</span><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-bottom: 7.5pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">TEDAVİ- Glukokortikoidler<o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-bottom: 10.7pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l9 level1 lfo25; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Oral veya intravenöz
glukokortikoidler anafilaksi tedavisinde uzamış anafilaksi semptomlarını
önlemek amacı ile sıklıkla kullanılan ilaçlardır.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l9 level1 lfo25; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Hidrokortizon (10-100 mg) veya
metilprednisolon (1 mg/kg, maksimum 50 mg) tercih edilen steroidlerdir.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l9 level1 lfo25; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Etkileri geç başladığı için
(4-6 saat) anafilaksinin akut tedavisinde etkinlikleri azdır.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 110%; margin-bottom: 11.0pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l9 level1 lfo25; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 110%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="EN-US">BİFAZİK REAKSİYONLARI
ÖNLEMEK İÇİN KULLANILIR !!</span></i></b><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: 54.5pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">*</span><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">J Allergy Clin Immunol 2005;115(3 Suppl 2):S483-523.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l9 level1 lfo25; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Kortikosteroidlerin bifazik
reaksiyonları önlediğine dair kesin kanıt yoktur.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: 6.85pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">**
Allergo J Int. 2021; 28:1-25</span><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-bottom: 7.4pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">Tedavi- literatür <o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-left: -.25pt;"><span lang="EN-US">Literatürde
pediatristlerle yapılan çalışmalarda, anaflaksi tedavisinde ilk tercih
Adrenalin diyenlerin oranını <o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 33.35pt; mso-list: l18 level1 lfo26; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span lang="EN-US">Pimentel-Hayashi ve ark %72,6,<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.4pt; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l18 level1 lfo26; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Krugman ve ark %72, <o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 128%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l18 level1 lfo26; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 128%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span lang="EN-US">Cetinkaya ve ark %92 olarak bildirmiştir.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 90%; margin-bottom: 9.25pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 18.0pt; line-height: 90%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">*Pimentel-Hayashi
JA, Navarrete-Rodriguez EM, Moreno-Laflor OI, Del Rio-Navarro BE. Physicians'
knowledge regarding epinephrine underuse in anaphylaxis. Asia Pac Allergy. 2020
, 22;10(4):e40.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 90%; margin-bottom: 9.25pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 18.0pt; line-height: 90%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">**Krugman
SD, Chiaramonte DR, Matsui EC. Diagnosis and management of food-induced
anaphylaxis: a national survey of pediatricians. Pediatrics.
2006;118(3):e554-60,</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 90%; margin-bottom: 9.25pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 18.0pt; line-height: 90%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">***Cetinkaya
F, Zübarioğlu AU, Göktaş S. Pediatricians' knowledge about recent advances in
anaphylaxis treatment in Istanbul, Turkey. Turk J Pediatr. 2009;51(1):19-21</span><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-bottom: 7.5pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">Tedavi- literatür<o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-bottom: 56.85pt; margin-left: 26.25pt; margin-right: 0cm; margin-top: 0cm; text-indent: -27.0pt;"><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Wingdings 3";">u </span><span lang="EN-US">Colleti ve ark . Brezilya'da pediatrik
yoğun bakımda calısan 43 pediatristle çalısmasında İM yolu seçen hekim oranını
%41.9 olarak bildirmiştir.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">*</span><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">Colleti Junior J, de Carvalho WB. Anaphylaxis Knowledge Among
Pediatric Intensivists in Brazil: A Multicenter Survey. Journal of Intensive
Care Medicine. 2017;32(10):593-59.</span><span lang="EN-US"><br clear="all" style="mso-special-character: line-break; page-break-before: always;" />
<o:p></o:p></span></p>
<h1 style="margin-bottom: 3.4pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">İZLEM<o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-bottom: 6.05pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l7 level1 lfo27; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Anafilakside bifazik
reaksiyonlar çoğunlukla ilk semptomların ortaya çıkmasından 4-6 saat sonra
oluştuğu için, hastaların izlem süresinin en az 46 saat olması kabul
edilmektedir .<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 4.85pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l7 level1 lfo27; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Solunum semptomları olan
hastalar en az 6-8 saat; <o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 81.1pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l7 level1 lfo27; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">hipotansiyon gelişen hastalar
ise en az 12-24 saat yakın takip edilmelidir.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 107%; margin-bottom: .0001pt; margin: 0cm; text-indent: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 22.0pt; line-height: 107%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">*Pediatric Emergency
Care,2008;24(12):861-866</span><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-left: -.25pt;"><span lang="EN-US">TABURCULUK<o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-left: 33.35pt; mso-list: l3 level1 lfo28; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span lang="EN-US">Taburculuk öncesi riskli durumlar değerlendirilmeli,<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 10.05pt; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l3 level1 lfo28; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">hastaya ve bakım veren kişiye
yazılı olarak acil eylem planı verilmeli, <o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 33.35pt; mso-list: l3 level1 lfo28; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span lang="EN-US">adrenalin oto-enjektör reçete edilip nasıl kullanacağı öğretilmeli
ve hangi durumlarda kullanıldığı anlatılmalıdır.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 88.5pt; margin-left: 33.35pt; margin-right: 0cm; margin-top: 0cm; mso-list: l3 level1 lfo28; text-indent: -33.35pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Hasta alerji uzmanına
yönlendirilmelidir .<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">*Allergo
J Int. 2021; 28:1-25.</span><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-left: -.25pt;"><span lang="EN-US">AOE <o:p></o:p></span></h1>
<p class="MsoNormal" style="line-height: 110%; margin-bottom: 44.75pt; margin-left: 27.0pt; margin-right: 227.25pt; margin-top: 0cm; mso-list: l6 level1 lfo29; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 110%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-family: "Comic Sans MS"; mso-bidi-font-family: "Comic Sans MS"; mso-fareast-font-family: "Comic Sans MS";">AOE,
ülkemizde Penepin adı ile üretilmektedir.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 110%; margin-bottom: 93.75pt; margin-left: 27.0pt; margin-right: 227.25pt; margin-top: 0cm; mso-list: l6 level1 lfo29; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 110%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-family: "Comic Sans MS"; mso-bidi-font-family: "Comic Sans MS"; mso-fareast-font-family: "Comic Sans MS";">AOE
çocuklarda 7,5-25 kg arası 0.15 mg/doz; </span><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 110%; mso-bidi-font-family: "Wingdings 3"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Wingdings 3";">u </span><span lang="EN-US" style="font-family: "Comic Sans MS"; mso-bidi-font-family: "Comic Sans MS"; mso-fareast-font-family: "Comic Sans MS";">25
kg üzerinde 0.3 mg/doz uygulanmalıdır.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; mso-bidi-font-family: "Comic Sans MS"; mso-fareast-font-family: "Comic Sans MS";">*</span><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">J Allergy Clin Immunol, 2002;109:171-5.</span><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-bottom: 71.9pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">AOE<o:p></o:p></span></h1>
<p class="MsoNormal" style="line-height: 107%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 45.05pt; margin-right: 0cm; margin-top: 0cm; text-indent: 0cm;"><br /></p>
<p class="MsoNormal" style="line-height: 107%; margin-bottom: .0001pt; margin: 0cm; text-indent: 0cm;"><span lang="EN-US"><a href="https://www.youtube.com/watch?v=qn9ciL7l8T4"><span style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 107%; mso-bidi-font-family: "Wingdings 3"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Wingdings 3"; text-decoration: none; text-underline: none;">u</span></a></span><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 107%; mso-bidi-font-family: "Wingdings 3"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Wingdings 3";"> </span><span lang="EN-US"><a href="https://www.youtube.com/watch?v=qn9ciL7l8T4"><span style="color: #3fcde7;">https://www.youtube.com/watch?v=qn9ciL7l8T4</span></a><br clear="all" style="mso-special-character: line-break; page-break-before: always;" />
<o:p></o:p></span></p>
<h1 style="margin-bottom: 7.5pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">AOE - literatür<o:p></o:p></span></h1>
<p class="MsoNormal" style="margin-bottom: 45.25pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l8 level1 lfo30; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Thomson ve ark. Avustralya da
yaptığı bir çalışmasında anafilaksi tanısı alan hastaların %81.9 una AOE reçete
edildigini, ancak %41.1’ine nasıl kullanılacağının öğretilmediğini tespit
etmiştir.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: 83.0pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">*Thomson
H, Seith R, Craig S. Downstream consequences of diagnostic error in pediatric
anaphylaxis. BMC Pediatr. 2018; 7;18(1):40.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom: 13.1pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l8 level1 lfo30; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Yılmazbaş ve ark. anafilaksi
nedeniyle 4 hastaya AOE reçete edildiğini, ancak hiç bir hastanın atak
sırasında kullanmadığını belirlemişlerdir.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">* </span><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">Yılmazbas P, Ozceker D, Adiguzel O, Terzi, O. Korkulu rüya
anafilaksi: Tek merkez deneyimi. </span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">Çocuk
Dergisi - Journal of Child 2021;21(1):42-47</span><span lang="EN-US"><o:p></o:p></span></p>
<h1 style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US">ADRENALİN OTO ENJEKTÖRÜ<span style="mso-spacerun: yes;"> </span>(AOE)<o:p></o:p></span></h1>
<p class="MsoNormal" style="line-height: 108%; margin-bottom: 3.9pt; margin-left: -.75pt; margin-right: 0cm; margin-top: 0cm; text-indent: 0cm;"><span lang="EN-US" style="font-size: 26.0pt; line-height: 108%; mso-bidi-font-size: 11.0pt;">Adrenalin
oto-enjektör (AOE) reçete edilmesi gereken hastalar:</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 108%; margin-bottom: 3.9pt; margin-left: 27.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo31; text-indent: -27.5pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 108%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 26.0pt; line-height: 108%; mso-bidi-font-size: 11.0pt;">1. Anafilaksi öyküsü olan tüm
hastalar</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 108%; margin-bottom: 5.55pt; margin-left: 27.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo31; text-indent: -27.5pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 108%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 26.0pt; line-height: 108%; mso-bidi-font-size: 11.0pt;">2. Daha önce sistemik alerjik
reaksiyon öyküsü olan hastalar</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 108%; margin-bottom: 3.9pt; margin-left: 27.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo31; text-indent: -27.5pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 108%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 26.0pt; line-height: 108%; mso-bidi-font-size: 11.0pt;">3. Besin alerjisi ile birlikte
astımı olan hastalar</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 108%; margin-bottom: 43.7pt; margin-left: 27.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo31; text-indent: -27.5pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 108%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 26.0pt; line-height: 108%; mso-bidi-font-size: 11.0pt;">4. Yerfıstığı, balık ve kabuklu
deniz hayvanlarına alerjisi olduğu bilinen hastalar</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 108%; margin-bottom: 38.15pt; margin-left: 27.5pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo31; text-indent: -27.5pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 21.0pt; line-height: 108%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 26.0pt; line-height: 108%; mso-bidi-font-size: 11.0pt;">Ig E aracılı erken tip besin
alerjisi olan hastalara da AOE reçete edilmesi düşünülmelidir.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 104%; margin-bottom: .8pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="font-family: "Comic Sans MS"; font-size: 20.0pt; line-height: 104%; mso-bidi-font-family: "Comic Sans MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Comic Sans MS";">*
Çocuk Dergisi 2017; 17(4):139-144.</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l4 level1 lfo32; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">Anafilaksinin ne zaman
gelişebileceği önceden öngörülemediği ve tedavi<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 128%; margin-bottom: 43.6pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l4 level1 lfo32; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 128%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">edilmediği durumda ölümle
sonuçlanabildiği için önceden hazırlıklı </span><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 128%; mso-bidi-font-family: "Wingdings 3"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Wingdings 3";">u </span><span lang="EN-US">olunması gerekir.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 128%; margin-left: 27.0pt; mso-list: l4 level1 lfo32; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 128%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]--><span lang="EN-US">Sağlık çalışanlarının anafilaksinin belirtileri, acil tedavisi ve
önlenmesi </span><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 128%; mso-bidi-font-family: "Wingdings 3"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Wingdings 3";">u </span><span lang="EN-US">hakkında
eğitimli olması önemlidir.<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 110%; margin-bottom: 50.7pt; margin-left: -.25pt; margin-right: 0cm; margin-top: 0cm;"><span lang="EN-US" style="color: #5fcbef; font-family: "Trebuchet MS",sans-serif; font-size: 36.0pt; line-height: 110%; mso-bidi-font-family: "Trebuchet MS"; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Trebuchet MS";">Son söz………….</span><span lang="EN-US"><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 107%; margin-bottom: 7.15pt; margin-left: 27.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l4 level1 lfo32; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 107%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><b style="mso-bidi-font-weight: normal;"><span lang="EN-US">ADRENALİN </span></b><span lang="EN-US">İÇİN:<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l4 level1 lfo32; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">BİR KONTRENDİKASYON YOK<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l4 level1 lfo32; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">ŞÜPHELENDİĞİN ANDA<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l4 level1 lfo32; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">1 MG /ML. ( 1/1 LİK)
ADRENALİNDEN<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l4 level1 lfo32; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">UYLUK YAN KASA İM<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l4 level1 lfo32; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">ÇOCUKTA MAX. 3 DİZYEM<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 27.0pt; mso-list: l4 level1 lfo32; text-indent: -27.0pt;"><!--[if !supportLists]--><span lang="EN-US" style="color: #5fcbef; font-family: "Wingdings 3"; font-size: 22.5pt; line-height: 103%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";"><span style="mso-list: Ignore;">u<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US">ERİŞKİNDE MAX. 5 DİZYEM UYGULA<o:p></o:p></span></p>
</div>
<span lang="EN-US" style="color: #404040; font-family: "Calibri",sans-serif; font-size: 28.0pt; line-height: 103%; mso-ansi-language: EN-US; mso-bidi-font-size: 11.0pt; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US;"><br clear="all" style="mso-break-type: section-break; page-break-before: always;" />
</span>
<p class="MsoNormal" style="line-height: 107%; margin-bottom: .0001pt; margin: 0cm; text-indent: 0cm;"><span lang="EN-US"><o:p> </o:p></span></p>Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-14111191601089487092021-05-31T06:33:00.001-07:002021-05-31T06:52:03.355-07:00topikal steroid sınıflaması<p><b><i>Topikal kortikosteroidlerin güçlerine göre sınıflandırılması (Niedner sınıflaması) </i></b></p><p><br /></p><p><u>Sınıf IV (Çok güçlü) </u></p><p>Klobetazol propiyonat - <b>dermovate</b></p><p>Betametazon dipropiyonat -</p><p>Diflukortolon valerat </p><p><br /></p><p><u>Sınıf III </u></p><p>Mometazon furoat -<b>elocon, momecon #</b></p><p>Dflukortolon valerat </p><p>Flutikazon propiyonat- <b>cutivate #</b></p><p> Betametazon valerat - <b>betnovat</b></p><p>Halometazon monohidrat </p><p>Halsinonid
Fluokortolon </p><p><br /></p><p><u>Sınıf II </u></p><p>Fluokortolon </p><p>Flumetazon pivalat</p><p> Halsinoid </p><p>Flusinolon asetonid</p><p> Prednikarbat </p><p>Metilprednizolon aseponat - <b>advantan </b></p><p>Hidrokortizon butirat - <b>locoderm</b> *</p><p>Klobetazon butirat - <b>eumovate</b></p><p>Triamsinolon asetonid</p><p><br /></p><p><u> Sınıf I (Az güçlü) </u></p><p>Klokortolon pivalat </p><p>Prednizolon - <b>prednol krem</b></p><p>Hidrokortizon asetat- <b>hipokort *</b></p><p> Hidrokortizon </p><p><br /></p><p><br /></p><p>* 1 yas altı </p><p># 2 yas ve üzeri </p><p>diğerleri 12 yas üstü </p><p> </p><p><br /></p><p> kaynak: </p><p>http://www.dermatoz.org.tr/2018/1/dermatoz18091ozelsayı.pdf</p><p><br /></p><p><br /></p>Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-53397503949567215622020-10-10T01:16:00.002-07:002020-12-06T23:42:25.814-08:00antiviral aromatik yağlar<p> </p><p><br /></p><p><span style="background-color: white; font-family: "Times New Roman", stixgeneral, serif; font-size: 15.9991px; vertical-align: inherit;"><span style="vertical-align: inherit;">Bir çalışmada tarçın ( </span></span><em style="background-color: white; font-family: "Times New Roman", stixgeneral, serif; font-size: 15.9991px;"><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Cinnamomum zeylanicum</span></span></em><span style="background-color: white; font-family: "Times New Roman", stixgeneral, serif; font-size: 15.9991px; vertical-align: inherit;"><span style="vertical-align: inherit;"> ), bergamot ( </span></span><em style="background-color: white; font-family: "Times New Roman", stixgeneral, serif; font-size: 15.9991px;"><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Citrus bergamia</span></span></em><span style="background-color: white; font-family: "Times New Roman", stixgeneral, serif; font-size: 15.9991px; vertical-align: inherit;"><span style="vertical-align: inherit;"> ), limon otu ( </span></span><em style="background-color: white; font-family: "Times New Roman", stixgeneral, serif; font-size: 15.9991px;"><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Cymbopogon flexuosus</span></span></em><span style="background-color: white; font-family: "Times New Roman", stixgeneral, serif; font-size: 15.9991px; vertical-align: inherit;"><span style="vertical-align: inherit;"> ), kekik ( </span></span><em style="background-color: white; font-family: "Times New Roman", stixgeneral, serif; font-size: 15.9991px;"><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Thymus vulgaris</span></span></em><span style="background-color: white; font-family: "Times New Roman", stixgeneral, serif; font-size: 15.9991px; vertical-align: inherit;"><span style="vertical-align: inherit;"> ) ve lavanta ( </span><em><span style="vertical-align: inherit;">Lavandula angustifolia</span></em><span style="vertical-align: inherit;"> ) içeren ticari uçucu yağların influenza tip A'ya (H1N1) karşı in vitro antiviral etkisini değerlendirdi.</span></span><em style="background-color: white; font-family: "Times New Roman", stixgeneral, serif; font-size: 15.9991px;"><span style="vertical-align: inherit;"></span></em><span style="background-color: white; font-family: "Times New Roman", stixgeneral, serif; font-size: 15.9991px; vertical-align: inherit;"><span style="vertical-align: inherit;">). </span></span></p><p><span style="background-color: white; font-family: "Times New Roman", stixgeneral, serif; font-size: 15.9991px; vertical-align: inherit;"><span style="vertical-align: inherit;">Yağlar sıvı fazda% 0.3 konsantrasyonda ve buhar fazında test edildi.</span></span></p><p><span style="background-color: white; font-family: "Times New Roman", stixgeneral, serif; font-size: 15.9991px; vertical-align: inherit;"><span style="vertical-align: inherit;"> </span><span style="vertical-align: inherit;">Tarçın, bergamot, kekik ve limon otu yağları sıvı fazda% 100 H1N1 inhibisyonu gösterirken, lavanta esansiyel yağı inhibisyonu% 85 idi.</span></span></p><p><span style="background-color: white; font-family: "Times New Roman", stixgeneral, serif; font-size: 15.9991px; vertical-align: inherit;"><span style="vertical-align: inherit;"> </span><span style="vertical-align: inherit;">Bununla birlikte, buhar fazında, 30 dakikalık maruziyetten sonra sadece tarçın yaprağı uçucu yağı için% 100 inhibisyon gözlenmiştir. </span></span></p><p><span style="background-color: white; font-family: "Times New Roman", stixgeneral, serif; font-size: 15.9991px; vertical-align: inherit;"><span style="vertical-align: inherit;">Bergamot, limon otu, kekik ve lavanta uçucu yağları sırasıyla% 95,% 90,% 70 ve% 80 inhibisyon oranları göstermiştir </span></span></p><p>American Journal of Essential Oils and Natural Products 2014; 2 (1): 47-53</p><p><br /></p><p><br /></p>Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-87132010980155521342020-10-03T22:55:00.003-07:002020-10-03T22:55:49.561-07:00aromaterapıde kullanılan yaglar<p><b> BAY LAUREL</b> (Laurel Leaf, Bay Leaf, Sweet Bay)</p><p>Laurus nobilis.1,8-Cineole 18.8%–68.8%</p><p>Avoid with children under age 3, particularly around the nose and</p><p>mouth. Use very cautiously in children under age 5 due to high 1,8-</p><p>cineole content. </p><p>Use very cautiously during pregnancy and lactation due to potentially</p><p>high methyl eugenol content. </p><p>Do not take orally due to high methyl eugenol content. Methyl eugenol</p><p>is considered an animal carcinogen and a possible human carcinogen.</p><p>May interact with blood pressure medications based on a study with an</p><p>ethanolic extract of bay laurel</p><p>Avoid with epilepsy and Parkinson’s disease due to 1,8-cineole</p><p>content.</p><p>May interfere with pentobarbital and other barbiturates (medications</p><p>for anxiety and insomnia) based on 1,8-cineole content.</p><p><br /></p><p><b>BERGAMOT</b></p><p>Citrus bergamia Risso,Limonene 10.5%–53.2%</p><p>Very photosensitizing,</p><p>May interfere with the enzymes responsible for drug metabolism</p><p>(NSAIDs, proton-pump inhibitors, acetaminophen, antiepileptics,</p><p>immune modulators, blood-sugar medications, blood pressure</p><p>medications, antidepressants, antipsychotics, diabetic medications,</p><p>antihistamines, antibiotics, and anesthetics).</p><p><br /></p><p><b>CAMPHOR</b> (Hon-Sho, True Camphor)Camphor 36.5%–98.0%</p><p>Cinnamomum camphora, Laurus camphora</p><p>Avoid with children under 6 due to high camphor content. Several</p><p>cases of camphor poisoning and/or seizures from ingestion and topical</p><p>application have been reported in children.</p><p>Camphor ingestion may lead to abortion.</p><p>Avoid with epilepsy and Parkinson’s disease due to camphor content.</p><p>camphor may negatively impact red blood cells and increase the risk of jaundice in children</p><p>with Glucose-6-phosphate dehydrogenase deficiency (G6PD).</p><p>Avoid with those who have a compromised liver due to the risk of</p><p>increased liver enzymes and liver damage.</p><p><br /></p><p><b>CEDARWOOD</b></p><p>Cedrus atlantica, Cedrus deodara.</p><p>None currently known.Alpha-pinene 14.9%–79.4%</p><p>CINNAMON BARK (Ceylon Cinnamon, True Cinnamon)(E)-Cinnamaldehyde 50.5%–91.0%</p><p>Avoid during pregnancy and lactation.</p><p>May interact with aspirin, blood pressure, antiplatelet, and</p><p>anticoagulant medications, and increase the risk of bleeding among</p><p>people with bleeding disorders.</p><p>May interact with antibiotics and possibly enhance their effects..</p><p><br /></p><p><b>CITRONELLA (</b>Java Citronella)</p><p>Cymbopogon winterianus.Citronellal 26.5%–42.8%</p><p>Caution is advised during pregnancy and lactation due to citral content.</p><p>There is a low risk that when citronella is taken orally it may interfere</p><p>with enzymes responsible for metabolizing medications (NSAIDs,</p><p>proton-pump inhibitors, acetaminophen, antiepileptics, immune</p><p>modulators, blood-sugar medications, blood pressure medications,</p><p>antidepressants, antipsychotics, diabetic medications, antihistamines,</p><p>antibiotics, and anesthetics).</p><p>May interfere with medications used to treat high blood pressure</p><p>(calcium channel blockers) and cause low blood pressure according to</p><p>animal research</p><p><br /></p><p><b>CLARY SAGE</b></p><p>Salvia sclarea.Linalyl Acetate 16.9%–60.8%</p><p>Clary sage contains the phytoestrogen sclareol, which can either block</p><p>or mimic the action of estrogen according to current knowledge.</p><p>Avoid with barbiturates.</p><p><br /></p><p><b>CLOVE BUD</b></p><p>Syzygium aromaticum, Eugenia caryophyllata.Eugenol 69.8%–87.0%</p><p>Caution with pregnancy and lactation.</p><p>May interact with aspirin, blood pressure, antiplatelet, and</p><p>anticoagulant medications, and increase the risk of bleeding among</p><p>people with bleeding disorders.</p><p>May interact with MAOI antidepressants.</p><p><br /></p><p><b>CYPRESS</b> (Mediterranean Cypress)</p><p>Cupressus sempervirens.Alpha-pinene 30.0%–64.2%</p><p><br /></p><p>May interact with aspirin, blood pressure, antiplatelet, and</p><p>anticoagulant medications, and increase the risk of bleeding among</p><p>people with bleeding disorders.</p><p><br /></p><p><br /></p><p><b>EUCALYPTUS</b></p><p>Eucalyptus globulus, 1,8-Cineole 33.6%–83.9%</p><p>Eucalyptus radiata.1,8-Cineole 22.4%–74.3%</p><p><br /></p><p>Avoid with children under age 3, particularly around the nose and</p><p>mouth. Use very cautiously in children under age 5 due to high 1,8-</p><p>cineole content.</p><p>Avoid with epilepsy and Parkinson’s disease due to 1,8-cineole</p><p>content.</p><p>May interfere with pentobarbital and other barbiturates</p><p><br /></p><p><b>FRANKINCENSE</b></p><p>Boswellia sacra, Boswellia carterii (B. carteri),Alpha-pinene 2.0%–64.0%</p><p>May interfere with the enzymes responsible for metabolizing</p><p>medications (NSAIDs, proton-pump inhibitors, acetaminophen,</p><p>antiepileptics, immune modulators, blood-sugar medications, blood-</p><p>pressure medications, antidepressants, antipsychotics, diabetic</p><p>medications, antihistamines, antibiotics, and anesthetics).</p><p><br /></p><p>GERANIUM (Rose Geranium)</p><p>Pelargonium graveolens,Citronellol 2.4%–45.7%</p><p>Geraniol 1.1%–38.4%</p><p>May interfere with the enzymes responsible for metabolizing</p><p>medications (NSAIDs, proton-pump inhibitors, acetaminophen,</p><p>antiepileptics, immune modulators, blood-sugar medications, blood-</p><p>pressure medications, antidepressants, antipsychotics, diabetic</p><p>medications, antihistamines, antibiotics, and anesthetics).</p><p>May interact with diabetes medications and cause low blood sugar.</p><p>GERMAN CHAMOMILE (German Camomile, Blue</p><p>Chamomile)</p><p>Matricaria recutita, Matricaria.Chamazulene 0.7%–61.3%</p><p>Bisabolol Oxide A 3.1%–56.0%</p><p>May interact with aspirin, blood-pressure, antiplatelet, and</p><p>anticoagulant medications, and increase the risk of bleeding among</p><p>people with bleeding disorders.</p><p>May interfere with the enzymes responsible for metabolizing</p><p>medications</p><p><br /></p><p>dr. scott johnsonevidence based esseintial oil therapy 2015 </p>Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-41686267407968224672020-10-03T06:16:00.002-07:002020-10-03T06:18:40.021-07:00çocuklarda B 12 vitamini tedavisi<p> </p><p>normal değerler: 200-350 mikrogram 900 e kadar normal..<100 ağır eksiklik,</p><p>b 12 düzeyi normalken b 12 vit. eksikliği olabilir.beraberinde demir eksikliği varsa MCV yükselmeyebilir.</p><p> 12 tedavisi verilirken , 2 .haftada demir tedavisi vermek gerekebilir.</p><p> b12 eksikliğinde kan da : b12 . folat, ure keratinin, ALT AST, TIT</p><p>holotranskobalamin aktif form.</p><p>metilmalonik asit: b 12 vit, homosistein, hem 1 2 , hem folat eks. gösterir.</p><p>B 12 vitamin tedavi dozu: 10- 30 microgram/kg/gun </p><p>500 microgram/ gun uygun doz 3 ay. 3 ay sonra kontrol.</p><p><br /></p><p>ted:</p><p> oral tedavi ile parentral tedavi arasında fark yok.</p><p> oral tedavi ile sublingual tedavi arasında fark yok </p><p> ilk hafta 1000 mcgr / gün 7 gün .sonra 100 mcgr. haftada bir. 1 ay</p><p>agır pernisiyoz anemide: </p><p>IM: 100- 1000mcgr 1 hafta he rgün</p><p>2 hafta : 2 gün / hafta</p><p>2 hafta : 1 gün / hafta</p><p>sonra ayda bir .</p><p><br /></p><p>PO: 250-1000 mcgr 1 hafta her gun</p><p>2 hafta haftada 2</p><p> 2 hafta haftada 1 </p><p>sonra ayda bir ..</p><p><br /></p><p>b12 yuksekliği </p><p><900</p><p>oral alımı dışla.</p><p>enfeksiyon hastalıkların iyileşme döneminde</p><p>otoimmun hastalıklarda,</p><p>inflamatuvar hast</p><p> KC bobrek hastalıklarında</p><p>malignitede ( solid tm.)</p><p>tetkik: hemogram </p><p>crp sedim ,TİT, MMA , homosistein</p><p>biokimya , radyoloji.</p><p><br /></p><p><br /></p><p><br /></p><p><br /></p><p><br /></p><p><br /></p><p><br /></p><p><br /></p>Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-74948692456972274742020-05-08T04:27:00.000-07:002020-05-08T04:31:48.342-07:00QUORUM SENSİNG EOQUORUM SENSİNG inhibisynu yapan esansiyel yağlar:<br />
pseudomanas: clove, tarcın nane, gül, lavanta<br />
e.coli: nane, gül, lavanta, biberiye, ıtırUzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-65776968000185995422020-05-07T04:57:00.000-07:002020-05-07T04:57:04.729-07:00QUORUM SENSINGQUORUM SENSING (ÇEVREYİ ALGILAMA SİSTEMİ)
İNHİBİTÖRLERİ: Bakteriyel enfeksiyonların kontrolü ve
tedavisi için umut vaat eden yeni stratejiler<br />
<br />
Doç. Dr. Gülgün TINAZ<br />
<br />
<br />
Bakteriler birbirleriyle nasıl ileti
șim kuruyorlar?
•Bakteriler birbirleriyle ileti
șim kurmak için küçük sinyal
molekülleri kullanıyorlar<br />
Bakteriler bu sinyal molekülleri aracılığıyla yeterli ço
ğunlu
ğa
ula
șıp ula
șmadıklarını izlemekte ve yeter ço
ğunlu
ğa ula
ș
tıkları
anda da virülens faktörlerinin üretimi gibi kritik gen
ekspresyonları tetiklenmektedir.<br />
<br />
Hücreler arası iletișimi sağlayan bu haberleșme sistemi
çevreyi algılama (quorum sensing) olarak adlandırılır.
•Bu olay bakteriye kendi hücre populasyon yoğunluğunu
izleme ve buna bağlı olarak davranıșlarını düzenlenme olanağı
verir. <br />
<br />
Böylelikle, konakta enfeksiyon olu
șturabilecek yeterli
ço
ğunlu
ğa ula
șıncaya kadar ba
ğıșıklık sistemi tarafından
patojen bakterinin fark edilmemesi sa
ğlanarak ba
șarılı bir
enfeksiyon süreci olu
șturulur.<br />
<br />
Biyofilm, bakteriyi ba
ğıșıklık sisteminden koruyan bir yapı….
•Biyofilm içindeki bakteri planktonik bakteriye göre
antibiyotiklere 1000 kat daha dirençli!!!!<br />
<br />
Son zamanlarda yapılan araștırmalar, bakteriler arası iletișim sisteminin
bozulması durumunda bakterilerin koordineli davranamayacakları,
konakta kolonize olma yeteneklerinin azalacağı ve bunun sonucunda
bașarılı bir enfeksiyon süreci ortaya koyamayacaklarını göstermektedir<br />
<br />
<br />
Günümüzde bakteriyel enfeksiyonlar ile sava
ș için tercih edilen
antibiyotik kullanımı gibi klasik yöntemler;
•protein sentezi,
•DNA replikasyonu ve
•hücre duvarı sentezi gibi
bakteriler için önemli i
șlemleri
engelleyerek onları öldürerek yok
etme temeline dayanmaktadır.<br />
Ancak bu yöntemler bir süre sonra antibiyotiklere kar
șı dirençli
populasyonların ortaya çıkmasına, bu da, kullanılan antibiyotiklerin
giderek etkisiz kalması, dolayısıyla hastalıkların tam anlamıyla tedavi
edilememesi, direncin yayılması ve ekonomik kayıplar ile
sonuçlanmaktadır.<br />
<br />
<br />
Dolayısıyla bakterileri direk öldürmek yerine aralarındaki
haberle
șme sistemini bloke ederek bakteriyel
enfeksiyonları tedavi etmek ve kontrol altında tutmak,
patojenlerle sava
șta çok umut vaat eden yeni bir strateji
olarak dü
șünülmektedir.<br />
<br />
1- Doğal İnhibitörler
2- Sentetik Analoglar
3- Bazı İlaçlar<br />
<br />
<br />
<br />
1- Doğal İnhibitörler Gram-negatif bakterilerde çevreyi algılama sistemini bloke etti
ği tespit
edilen ilk bile
șik, kırmızı bir deniz algi olan Delisea pulchra’dan izole
edilen halojenlenmi
ș furanonlardır.<br />
<br />
Patulin
Penicillic asit 4-nitro-pyridine-N-oxide (4-NPO)
sarımsak özütü
cinnamaldehyde vanillin
p-coumaric acid
catechin<br />
gibi birkaç doğal bileșiğin daha Gram-negatif bakterilerin
çevreyi algılama sistemini etkilediğini rapor edilmiștir.<br />
<br />
Ancak bu bile
șiklerin ço
ğunun ya toksik olmaları
ya da tolere edilebilir dozlarda etki
gösterememeleri nedeniyle insan kullanımına çok
uygun olmadıkları görülmü
ștür. <br />
<br />
<br />
2- Sentetik Analoglar ve Sentetik Bile
șikler
P. aeruginosa sinyal molekülü
Hücreler arası ileti
șimi sa
ğlayan sinyalin alınmasını önlemek amacıyla reseptöre (LuxR-tipi)
kar
șı yarıșan sentetik moleküller<br />
<br />
<br />
<br />
Bilgisayar destekli molekül dizaynı ile QSI molekül taraması çalıșmaları
ile yapısal olarak AHL’ lara benzerlik göstermeyen bazı moleküllerin de
bazı bakteri türlerinde QS sistemini inhibe etti
ği görülmü
ștür.<br />
<br />
3- Bazı Bilinen İlaçlar
•İlaç pazarındaki bazı ilaçların kullanımlarına neden olan biyolojik
etkilerine ilave olarak quorum sensing aktivitesine de sahip olduları
gösterilmiștir.
•Bazı makrolid ve non-makrolid antibiyotiklerin sub-MIC
değerlerinde, Gram (-) bakterilerin quorum sensing sistemi üzerine
etkileri rapor edilmiștir.
•Salicylic acid, nifuroxazide ve chlorzoxazone’un P. aeruginosa
quorum sensing sistemini inhibe ettiği görülmüștür.<br />
<br />
•Tobramycinin , P. aeruginosa da elastaz üretimini azalttığı gözlenmiștir.
•Bilinen ilaç moleküllerinin bakteriyel QS üzerindeki etkileri onların
farklı medikal uygulamalarda kullanılma potansiyelleri olduğunu
göstermektedir<br />
<br />
<br />
Eğer insan kullanımına uygun QS inhibitörler geliștirilebilirse,
bu moleküllerin antibiyotiklerden farkı ne olacak?
•Üremeyi direk olarak etkilemeyeceklerinden, dirençli bakterilerin
gelișimine neden olmayacakları,
•konakta mevcut faydalı bakteri komünitelerini yok etmeyecekleri
umulmaktadır.<br />
<br />
QS inhibitörlerinin mevcut antibiyotiklerle birlikte
kullanılarak onların etkisini artıracakları ve raf ömrünü
uzatacağı umulmaktadır.<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />
Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-39453715820464835912020-05-06T03:32:00.001-07:002020-07-01T12:30:40.633-07:00ÇOCUKLARDA VİTAMİNLER<br />
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<span style="color: #222222;"><span style="font-family: "times new roman" , serif;"><span style="font-size: medium;"><span style="font-style: normal;"><span style="font-weight: normal;">Vitamin
ve mineraller bağışıklıkta önemlidir. A, B , C , D , E, K
vitaminleri ve demir , çinko , selenyum gibi minareller bağışıklık sistemi için gereklidir. </span></span></span></span></span>
</div>
<div style="margin-bottom: 0cm; orphans: 2; widows: 2;">
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<span style="font-family: "times new roman" , serif;"><span style="font-size: medium;"><span style="font-style: normal;"><span style="font-weight: normal;">*</span></span><span style="font-style: normal;"><b>A
vitamini</b></span><span style="font-style: normal;"><span style="font-weight: normal;">:
</span></span><span lang="zxx"><span style="font-style: normal;"><span style="font-weight: normal;">Yumurta,
süt, havuç, domates, kabak , ıspanak, koyu yeşil yapraklı ve
trabzon hurması, kayısı gibi turuncu sebzeler A vitamininden
zengin besinlerdir.</span></span></span></span></span></span></div>
<div style="margin-bottom: 0cm; orphans: 2; widows: 2;">
<span style="font-family: "times new roman" , serif;"><span style="font-size: medium;"><span style="color: #222222;"><span lang="zxx"><span style="font-style: normal;"><b>*B
vitamin</b></span></span></span><span style="color: #222222;"><span lang="zxx"><span style="font-style: normal;"><span style="font-weight: normal;">:
Kırmızı et, balık, süt, yumurta, ıspanak, domates, yeşil
yapraklı bitkiler, kuru baklagiler, muz. </span></span></span></span><span lang="zxx"><span style="font-style: normal;"><span style="font-weight: normal;">
</span></span></span></span></span>
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<span style="color: #222222;"><span style="font-family: "times new roman" , serif;"><span style="font-size: medium;"><span style="color: #343841;"><span lang="zxx"><span style="font-style: normal;"><span style="font-weight: normal;">*</span></span></span></span><span style="color: #343841;"><span lang="zxx"><span style="font-style: normal;"><b>C
vitamini:</b></span></span></span><span style="color: #343841;"><span lang="zxx"><span style="font-style: normal;"><span style="font-weight: normal;">
Limon, portakal, mandalina, dolmalık biber, maydanoz, kivi ve
greyfurt, kuşburnu bol miktarda C vitamini içerir.</span></span></span></span></span></span></span></div>
<div style="margin-bottom: 0cm; orphans: 2; widows: 2;">
<span style="color: #222222;"><span style="font-family: "times new roman" , serif;"><span style="font-size: medium;"><span style="color: #343841;"><span lang="zxx"><span style="font-style: normal;"><span style="font-weight: normal;">*</span></span></span></span><span lang="zxx"><span style="font-style: normal;"><b>D
vitamini : S</b></span></span><span lang="zxx"><span style="font-style: normal;"><span style="font-weight: normal;">üt
ürünleri, uskumru,sardalya, somon gibi yağlı balıklar, yumurta
sarısı, kuzu ciğeri, maydanoz, tatlı papates, ısırgan otu ,
mantar . </span></span></span></span></span></span>
</div>
<div style="margin-bottom: 0cm; orphans: 2; widows: 2;">
<span style="color: #222222;"><span style="font-family: "times new roman" , serif;"><span style="font-size: medium;"><span lang="zxx"><span style="font-style: normal;"><span style="font-weight: normal;">D
vitamini ağırlıklı olarak güneşten alınmalıdır.</span></span></span></span></span></span></div>
<div style="margin-bottom: 0cm; orphans: 2; widows: 2;">
<span style="color: #222222;"><span style="font-family: "times new roman" , serif;"><span style="font-size: medium;"><span style="color: #333333;"><span lang="zxx"><span style="font-style: normal;"><b>*E
Vitamini: </b></span></span></span><span style="color: #333333;"><span lang="zxx"><span style="font-style: normal;"><span style="font-weight: normal;">Antioksidan
özelliği vardır. Fındık, ceviz, badem, yeşil yapraklı
sebzeler, kuru baklagiller ve tahinde bulunur..</span></span></span></span><span lang="zxx"><span style="font-style: normal;"><span style="font-weight: normal;">
</span></span></span></span></span></span>
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<div style="margin-bottom: 0cm; orphans: 2; widows: 2;">
<span style="color: #222222;"><span style="font-family: "times new roman" , serif;"><span style="font-size: medium;"><span lang="zxx"><span style="font-style: normal;"><b>*K
vitamini:</b></span></span><span lang="zxx"><span style="font-style: normal;"><span style="font-weight: normal;">
Koyu yeşil yapraklılar , brokoli, bamya , maydanoz , lahana, havuç.</span></span></span></span></span></span></div>
<div style="margin-bottom: 0cm; orphans: 2; widows: 2;">
<span style="font-family: "times new roman" , serif;"><span style="font-size: medium;"><span style="color: black;"><span lang="zxx"><span style="font-style: normal;"><span style="font-weight: normal;">*</span></span></span></span><span style="color: black;"><span lang="zxx"><span style="font-style: normal;"><b>Çinko</b></span></span></span><span style="color: black;"><span lang="zxx"><span style="font-style: normal;"><span style="font-weight: normal;">:
Kırmızı et, yumurta, ıspanak, süt, yoğurt, kabak çekirdeği
ve ceviz, fındık ve badem gibi yağlı tohumlar doğal bir
antioksidan olan çinko bakımından zengin besinlerdir</span></span></span></span></span></span></div>
<div style="orphans: 2; widows: 2;">
<span style="font-family: "times new roman" , serif;"><span style="font-size: medium;"><span style="color: #1d2129;"><span lang="zxx"><span style="font-style: normal;"><span style="font-weight: normal;"><span style="background: #ffffff;">*</span></span></span></span></span><span style="color: #1d2129;"><span lang="zxx"><span style="font-style: normal;"><b><span style="background: #ffffff;">Demir:</span></b></span></span></span><span style="color: #1d2129;"><span lang="zxx"><span style="font-style: normal;"><span style="font-weight: normal;"><span style="background: #ffffff;">
kırmızı et, yumurta, koyu yeşil yapraklı sebzeler, kuru
baklagiller, kereviz yaprağı, roka ve kuru kayısıdır. Demir C
vitamini ile beraber alındığında emilimi artar. </span></span></span></span></span><span style="color: black;"><span lang="zxx"><span style="font-style: normal;"><span style="font-weight: normal;">Sabah
kahvaltısında yumurtanın yanında C vitamininden zengin domates
ve sivri biber verilebilir. </span></span></span></span></span></span>
</div>
<div style="margin-bottom: 0cm; orphans: 2; widows: 2;">
<span style="color: #222222;"><span style="font-family: "times new roman" , serif;"><span style="font-size: medium;"><span style="color: #1d2129;"><span style="font-style: normal;"><span style="font-weight: normal;"><span style="background: #ffffff;"><br /></span></span></span></span></span></span></span></div>
Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-20507808704289449312020-04-29T01:29:00.002-07:002020-04-29T01:29:15.412-07:00QT yi uzatan ilaçlar<span style="background-color: white; border: 0px; box-sizing: border-box; color: #2c2f34; font-family: Roboto; font-size: 14px; font-weight: 600; list-style: none; margin: 0px; outline: none; padding: 0px;">Antimalaryal:</span><span style="background-color: white; color: #2c2f34; font-family: Roboto; font-size: 14px;"> Yüksek risk:, Quinidine, Quinine</span><br />
<span style="background-color: white; border: 0px; box-sizing: border-box; color: #2c2f34; font-family: Roboto; font-size: 14px; font-weight: 600; list-style: none; margin: 0px; outline: none; padding: 0px;">Azol antifungaller: </span><span style="background-color: white; color: #2c2f34; font-family: Roboto; font-size: 14px;">Orta risk: Fluconazole, </span><br />
<span style="background-color: white; border: 0px; box-sizing: border-box; color: #2c2f34; font-family: Roboto; font-size: 14px; font-weight: 600; list-style: none; margin: 0px; outline: none; padding: 0px;">Makrolid grubu antibiyotikler: </span><span style="background-color: white; color: #2c2f34; font-family: Roboto; font-size: 14px;">Orta risk: Azithromycin, Erythromycin, Clarithromycin</span><br />
<span style="background-color: white; border: 0px; box-sizing: border-box; color: #2c2f34; font-family: Roboto; font-size: 14px; font-weight: 600; list-style: none; margin: 0px; outline: none; padding: 0px;">Antihistaminikler;</span><span style="background-color: white; color: #2c2f34; font-family: Roboto; font-size: 14px;"> , Hydroxyzine, Terfenadine</span><br />
<span style="background-color: white; border: 0px; box-sizing: border-box; color: #2c2f34; font-family: Roboto; font-size: 14px; font-weight: 600; list-style: none; margin: 0px; outline: none; padding: 0px;">Antiemetikler: </span><span style="background-color: white; color: #2c2f34; font-family: Roboto; font-size: 14px;">Orta risk: Ondansetron (IV kullanım ile risk, oral kullanımdan daha büyüktür)</span><br style="background-color: white; border: 0px; box-sizing: border-box; color: #2c2f34; font-family: Roboto; font-size: 14px; list-style: none; margin: 0px; outline: none; padding: 0px;" /><span style="background-color: white; color: #2c2f34; font-family: Roboto; font-size: 14px;">Düşük-Orta risk: Granisetron, </span><br />
<span style="background-color: white; border: 0px; box-sizing: border-box; color: #2c2f34; font-family: Roboto; font-size: 14px; font-weight: 600; list-style: none; margin: 0px; outline: none; padding: 0px;">SSRI’lar (Trisiklik antidepresanlardan daha az): </span><span style="background-color: white; color: #2c2f34; font-family: Roboto; font-size: 14px;">Citalopram, Escitalopram, Fluoxetine </span><br />
<span style="background-color: white; border: 0px; box-sizing: border-box; color: #2c2f34; font-family: Roboto; font-size: 14px; font-weight: 600; list-style: none; margin: 0px; outline: none; padding: 0px;">Prokinetik:</span><span style="background-color: white; color: #2c2f34; font-family: Roboto; font-size: 14px;">Orta risk: Domperidone</span><br />
<span style="background-color: white; border: 0px; box-sizing: border-box; color: #2c2f34; font-family: Roboto; font-size: 14px; font-weight: 600; list-style: none; margin: 0px; outline: none; padding: 0px;">Bronkodilatörler</span><span style="background-color: white; color: #2c2f34; font-family: Roboto; font-size: 14px;"> </span><span style="background-color: white; border: 0px; box-sizing: border-box; color: #2c2f34; font-family: Roboto; font-size: 14px; font-weight: 600; list-style: none; margin: 0px; outline: none; padding: 0px;">(beta-2 agonistler)</span><span style="background-color: white; color: #2c2f34; font-family: Roboto; font-size: 14px;">;</span><span style="background-color: white; color: #2c2f34; font-family: Roboto; font-size: 14px;">Albuterol, Salmeterol, Terbutaline, Vilanterol</span>Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-59003670819244488982020-04-23T04:29:00.001-07:002020-04-23T05:47:07.884-07:00sarı kantaronsarı kantaron: hypericum perforatum<br />
yara iyilestici, bakterisitik, antiinflamatuvar etkili.<br />
son zamanlarda mild depresyon tedavisinde kullanılıyor.<br />
cidd ideprasyonda , organ transplantasyonunda, antidepressan, antikoagulan tedavi alanlarda , digoksin, teofilin alanlarda kullanılmamalıdır.<br />
içerdiği hipersini ile kanser oluşumunu engelledigi gösterilmiş.Kantaron hâlihazırda kanser tedavisinde
kullanılan sınırlı sayıdaki bitkilerden biridir
(Kintzios, 2006<br />
hiperforin ile aktif yara iyileştirici etkiye sahiptir.<br />
<br />
Saljic (1975)’in bildirdiğine
göre H. perforatum çiçek ekstraktından hazırlanan
merhem kullanıldığında birinci derece yanık 48
saat içinde iyileşmiştir<br />
hiperisin ve hiperforin antibaktel etkıye sahip<br />
<br />
Kantaron Yağı: Bu yağ iki şekilde hazırlanabilir.
Birinci yöntemde 100 gr kantaron çiçeği içinde
250 gr zeytinyağı bulunan bir şişeye konur. Bu
karışım ara sıra çalkalanarak 15 gün güneşte
bırakılır ve sonra pamuktan süzülür. Bu hazırlama
şekli ülkemizde oldukça yaygındır. Kantaron yağı hazırlanırken taze ya da
kurutulmuş çiçekler kullanılabilir. Yanık yaraları
ya da çıbanlar bu yağ ile pansuman yapılır
(Baytop, 1999).<br />
<br />
<img alt="Kantaron Yağının Yararları (Evde Nasıl Hazırlanır?) - Sağlık Haberleri" src="https://i2.milimaj.com/i/milliyet/75/0x410/5c8d5f9245d2a05010d639e5.jpg" />Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-68066424835345290652020-04-23T03:38:00.001-07:002020-04-23T03:38:56.649-07:00calendula officinalis ( aynı sefa bitkisi)Calendula Officinalis:<br />
dahili olarak mükoz membran enflamasyonu, peptik ulcus, GİS spazmında<br />
harici olarak yüzeyel kesik, yara iyilesmesinde kullanılır.<br />
boğaz agrısında ve peptik ülserde 1-2 gr yani bir tatlı kaşığı bitki 150 ml. sıcak suda 10 -15 dakika demlenir ve gunde 3 kez içilir.<br />
<br />
harici olarak 1 yemek kasıgı bitki 500 cc sıcak suda 15 dakika demlenir ve yaraya kompres yapılır .<br />
anticandidial ve antiviral etki ( influenza ve herpese karsı) gosterilmiş.<br />
hepatoprotekrif etki ve immnomodulator etkisi gosterilmiş.<br />
<br />
<br />
FFP monografı 2017<br />
ESCOP monographs 2003<br />
<br />
<img alt="Aynısefa çiçeğinin yararları nelerdir? Aynısefa hangi hastalıklara ..." 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" />Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-39920953717392271642020-03-26T06:37:00.001-07:002020-03-26T06:37:52.380-07:00#AROMATERAPİ<br />
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STRESS İLİŞKİLİ HALLER:<br />
clary<br />
cypress<br />
lavanta<br />
lemongrass<br />
paculi<br />
petitgrain<br />
vetiver<br />
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DEPRESYON:<br />
bergamot<br />
rom.papatyası<br />
geranıum<br />
lavanta<br />
lemongrass<br />
neroli<br />
orange<br />
patitgrain<br />
paculi<br />
pepermint<br />
rose<br />
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ANKSİYETE:<br />
bergamot<br />
german papatya<br />
clary<br />
frankincense<br />
geranuım<br />
lavanta<br />
lemon<br />
neroli<br />
tangarıne<br />
thyme<br />
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MIGREN/BASAGRISI:<br />
german papatya<br />
rom. papatya<br />
lavanta<br />
lemongrass<br />
citronella<br />
pepermint<br />
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BRUİSE:<br />
germ papatya<br />
geranuım<br />
lavanta<br />
helichurcyım<br />
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<br />Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-91895343531984696152020-03-24T06:24:00.000-07:002020-04-28T02:32:55.133-07:00AROMATERAPİ frankincenseImmunostimulant effects were observed by the EO present in frankincense oil (Boswellia carteri),<br />
in which the main constituents are α-pinene, octyl acetate, and α-thujene (depending on the origin of the plants). These compounds increased human lymphocyte proliferation, and this effect was comparable to that induced by the wellknown immunostimulants, such as the Echinacea purpurea extract and levamisole (Mikhaeil et al., 2003).<br />
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<br />Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-36738379978419720782020-03-24T05:08:00.003-07:002020-04-23T02:14:36.048-07:00AROMATERAPİ ölçüleriHelpful<span style="white-space: pre;"> </span>Measurement<span style="white-space: pre;"> </span>Equivalents<br />
2<span style="white-space: pre;"> </span>tablespoons =<span style="white-space: pre;"> </span>1<span style="white-space: pre;"> </span>ounce<br />
6<span style="white-space: pre;"> </span>teaspoons =<span style="white-space: pre;"> </span>1<span style="white-space: pre;"> </span>ounce<br />
1<span style="white-space: pre;"> </span>teaspoon =<span style="white-space: pre;"> </span>5<span style="white-space: pre;"> </span>ml<span style="white-space: pre;"> </span>(milliliters)<br />
1<span style="white-space: pre;"> </span>tablespoon =<span style="white-space: pre;"> </span>15<span style="white-space: pre;"> </span>ml<br />
<b>1<span style="white-space: pre;"> </span>ounce =<span style="white-space: pre;"> </span>30<span style="white-space: pre;"> </span>ml </b><br />
1<span style="white-space: pre;"> </span>teaspoon =<span style="white-space: pre;"> </span>100<span style="white-space: pre;"> </span>drops<br />
1<span style="white-space: pre;"> </span>tablespoon =<span style="white-space: pre;"> </span>300<span style="white-space: pre;"> </span>drops<br />
<div>
<br /></div>
Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-37438325068401622252020-03-24T04:38:00.001-07:002020-03-24T04:38:54.294-07:00AROMATERAPİ<b></b><br />
<b>ACHILLEA MILLEFOLIUM HERB. [YARROW] ASTERACEAE</b><br />
<div>
<br /></div>
<b><br /></b>
<b></b><br />
analgesic.... neuralgia, sprained ankle, sprains<br />
anticatarrhal ...colds, catarrh<br />
antiinflammator.... prostatitis, neuritis, rheumatism, see Table 4.6<br />
<br />
<div>
<div>
antiseptic....urinary infections </div>
<div>
choleretic...hepatobiliary deficiency, poor digestion</div>
<div>
cicatrizant</div>
<div>
decongestant... dysmenorrhoea</div>
<div>
digestive stimulant see Table 4.8</div>
<div>
diuretic </div>
<div>
emmenagogic... oligomenorrhoea, amenorrhoea </div>
<div>
expectorant </div>
<div>
febrifuge.... fevers </div>
<div>
hypotensor... hypertension</div>
<div>
litholytic... kidney stones </div>
<div>
vulnerary.... varicose ulcers</div>
</div>
<div>
<br /></div>
<div>
<br /></div>
not normally used for babies, children and pregnant women<br />
neurotoxic and abortive (Franchomme & Pénoël 2001 p. 348<b>) </b><br />
<b><br /></b>
<b><br /></b>
<b><br /></b>
<b><br /></b>
<b>BOSWELLIA CARTERI RES. DIST. [FRANKINCENSE, OLIBANUM] BURSERACEAE</b><br />
<br />
<div>
analgesic ....rheumatism, sports injuries</div>
<div>
<div>
antibacterial ....see Table 4.4 </div>
<div>
anticatarrhal.... asthma, bronchitis</div>
<div>
antidepressive .....nervous depression</div>
<div>
antiinfectious..... respiratory tract </div>
<div>
antiinflammatory..... rheumatism, see Table 4.6 </div>
<div>
antioxidant .....combats ageing process </div>
<div>
cicatrizant ......scars, ulcers, wounds </div>
<div>
energizing </div>
<div>
expectorant</div>
<div>
immunostimulant.... immunodeficiency</div>
</div>
<div>
<br /></div>
<div>
<div>
<b>CANANGA ODORATA FOL. [YLANG YLANG] ANNONACEAE</b></div>
</div>
<div>
<b><br /></b></div>
<div>
<div>
antidiabetic..... diabetes</div>
<div>
antiseptic.... intestinal infections </div>
<div>
antispasmodic..... cramp, colic </div>
<div>
balancing</div>
<div>
calming....... tachycardia, hyperpnoea, insomnia</div>
<div>
hypotensor.... hypertension</div>
<div>
tonic ......scalp, hair growth</div>
<div>
reproductive stimulant ......frigidity, impotence </div>
<div>
sedative<br />
<br />
** a folk remedy for asthma, boils, diarrhoea, headache, malaria, ophthalmia, rheumatism, stomach ailments (Duke & Wain 1981)</div>
</div>
<div>
<br /></div>
<div>
<br /></div>
<div>
<div>
CEDRUS ATLANTICA LIG. [ATLAS CEDARWOOD, SATINWOOD] ABIETACEAE</div>
</div>
<div>
<br /></div>
<div>
<div>
antiseptic... skin problems, scalp (with cade oil), urinary tract, eczema, pruritus (with bergamot oil) arterial regenerato... arteriosclerosis</div>
<div>
cicatrizant</div>
<div>
skin problems.. wounds</div>
<div>
lipolytic..... cellulite</div>
<div>
lymph tonic... cellulite, lymph circulation problems, water retention </div>
<div>
mucolytic.... bronchitis</div>
<div>
stimulant......scalp problems</div>
</div>
<div>
<br /></div>
<div>
**considered in France to be neurotoxic and abortive, and not normally used there for pregnant women and infants </div>
<div>
<br /></div>
<div>
<br /></div>
<div>
<div>
<b>CHAMAEMELUM NOBILE (= MATRICARIA CHAMOMILLA, ANTHEMIS NOBILIS) [ROMAN CHAMOMILE] ASTERACEAE</b></div>
</div>
<div>
<b><br /></b></div>
<div>
<div>
antianaemic..... anaemia </div>
<div>
antiinflammatory.............. eczema, gout, inflamed skin, rheumatic pain, urticaria, skin irritation after shaving, cracked nipples, inflamed gums, neuritis, see Table 4.6 </div>
<div>
antineuralgic</div>
<div>
antiparasitic</div>
<div>
antispasmodic.... migraines, headaches, (relaxes neuromuscular tension), infantile diarrhoea</div>
<div>
calming, sedative..... insomnia, irritability, migraine, nervous depression, nervous shock carminative..... gas, intestinal colic</div>
<div>
digestive.... indigestion, loss of appetite, see Table 4.8</div>
<div>
emmenagogic........ nervous menstrual problems </div>
<div>
menstrual.......... menopause, amenorrhoea, dysmenorrhoea </div>
<div>
ophthalmic...... conjunctivitis, sore tired eyes </div>
<div>
stimulant </div>
<div>
sudorific </div>
<div>
vulnerary........... boils, burns, wounds<br />
<br />
<br />
**chamomile tea may cause anaphylaxis, contact dermatitis or other hypersensitivity reactions in allergic individuals; persons known to be allergic to ragweeds should be cautious about drinking chamomile or yarrow teas (Tyler 1982) </div>
<div style="font-weight: bold;">
<br /></div>
</div>
<div>
<div style="font-weight: bold;">
CINNAMOMUM VERUM FOL. [CINNAMON LEAF] LAURACEAE</div>
<div style="font-weight: bold;">
<br /></div>
<div>
<div>
analgesic.... toothache, rheumatism, gout pain</div>
<div>
antiinfectious..... oropharyngitis, cystitis, acute bronchitis, rhinopharyngitis </div>
<div>
antiinflammatory..... stomatitis, salpingitis, enterocolitis, see Table 4.6 </div>
<div>
antifungal ....see Table 4.5</div>
<div>
antiparasitic</div>
<div>
antiviral.... see Table 4.7</div>
<div>
immunostimulant .......increase IgA </div>
<div>
neurotonic </div>
<div>
stimulating</div>
</div>
<div>
<br />
**eugenol (present in cinnamon leaf oil) is reported to have weak tumour promoting action on mouse skin and weak cytotoxic activity against HeLa cells<br />
**<br />
cinnamon leaf oil is dermocaustic on mucous surfaces and should not be used on babies and young children<br />
**** eugenol, eugenol acetate and methyl eugenol are reported to enhance trypsin activity in vitro (Leung & Foster 1996 p. 168)</div>
</div>
<div>
<br /></div>
<div>
<br /></div>
<div>
<div>
CINNAMOMUM VERUM CORT. [CINNAMON BARK] LAURACEAE</div>
</div>
<div>
<br /></div>
<div>
<br /></div>
<div>
<b>A</b>lexipharmic snake bites analgesic rheumatism antibacterial see Table 4.4 anticoagulant antifungal see Table 4.5 antiinfectious influenza, coughs, colds, diarrhoea, typhoid fever, tropical fevers, haemoptysis antiparasitic scabies, pediculosis antiputrescent antiseptic sprays to purify foul atmospheres, urinary infections antispasmodic colic, spasm due to infected enterocolitis antiviral warts, viral infections, see Table 4.7 astringent tooth socket pyorrhoea, diarrhoea bactericidal dysentery, enterocolitis, diarrhoea, cystitis (bacterial), urinary infection, vaginitis, leucorrhoea carminative flatulence emmenagogic oligomenorrhoea</div>
<div>
<br /></div>
<div>
<br /></div>
Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-24419026547850944862020-03-23T06:05:00.000-07:002020-03-23T06:05:26.318-07:00antiviral yağlarteatree,lavanta, limon, paculi, palmaroza, nioli,okaliptus, bergamotUzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-63058515153961654112020-03-23T00:28:00.000-07:002020-03-23T00:28:00.478-07:00viral ishal.<div style="background-color: white; color: #1d2129; font-family: Helvetica, Arial, sans-serif; font-size: 14px; margin-bottom: 6px;">
İSHALDE VİRAL ETKENLERİN ÖZELLİKLERİ:</div>
<div style="background-color: white; color: #1d2129; font-family: Helvetica, Arial, sans-serif; font-size: 14px; margin-bottom: 6px; margin-top: 6px;">
<b>Rota:</b></div>
<div style="background-color: white; color: #1d2129; font-family: Helvetica, Arial, sans-serif; font-size: 14px; margin-bottom: 6px; margin-top: 6px;">
ink. 1-3 gün. </div>
<div style="background-color: white; color: #1d2129; font-family: Helvetica, Arial, sans-serif; font-size: 14px; margin-bottom: 6px; margin-top: 6px;">
ishalden önce dışkı ile atılmaya başlar, ishalden sonra 10 gün daha atılır.<br />dışkı sulu, kan- mukus yok, </div>
<div style="background-color: white; color: #1d2129; font-family: Helvetica, Arial, sans-serif; font-size: 14px; margin-bottom: 6px; margin-top: 6px;">
süre 5-7 gün</div>
<div style="background-color: white; color: #1d2129; font-family: Helvetica, Arial, sans-serif; font-size: 14px; margin-bottom: 6px; margin-top: 6px;">
<br /></div>
<div style="background-color: white; color: #1d2129; font-family: Helvetica, Arial, sans-serif; font-size: 14px; margin-bottom: 6px; margin-top: 6px;">
<b>Noro: </b></div>
<div style="background-color: white; color: #1d2129; font-family: Helvetica, Arial, sans-serif; font-size: 14px; margin-bottom: 6px; margin-top: 6px;">
ink 1-2 gün .</div>
<div style="background-color: white; color: #1d2129; font-family: Helvetica, Arial, sans-serif; font-size: 14px; margin-bottom: 6px; margin-top: 6px;">
ateş yok .bulantı kusma ishal , karın ağrısı, halsizlik.. </div>
<div style="background-color: white; color: #1d2129; font-family: Helvetica, Arial, sans-serif; font-size: 14px; margin-bottom: 6px; margin-top: 6px;">
süre 1-2 gün</div>
<div style="background-color: white; color: #1d2129; font-family: Helvetica, Arial, sans-serif; font-size: 14px; margin-bottom: 6px; margin-top: 6px;">
<br /></div>
<div style="background-color: white; color: #1d2129; font-family: Helvetica, Arial, sans-serif; font-size: 14px; margin-bottom: 6px; margin-top: 6px;">
<b>Adeno:</b></div>
<div style="background-color: white; color: #1d2129; font-family: Helvetica, Arial, sans-serif; font-size: 14px; margin-bottom: 6px; margin-top: 6px;">
ink 3-10 gün.</div>
<div style="background-color: white; color: #1d2129; font-family: Helvetica, Arial, sans-serif; font-size: 14px; margin-bottom: 6px; margin-top: 6px;">
ishal sulu ve mukuslu , kusma ateş var.<br />ishalden sonra haftalarca atılmaya devam eder.<br />süre 2 haftaya kadar</div>
<div style="background-color: white; color: #1d2129; font-family: Helvetica, Arial, sans-serif; font-size: 14px; margin-bottom: 6px; margin-top: 6px;">
<br /></div>
<div style="background-color: white; color: #1d2129; display: inline; font-family: Helvetica, Arial, sans-serif; font-size: 14px; margin-top: 6px;">
<b>Astro:</b></div>
<div>
<div style="background-color: white; color: #1d2129; display: inline; font-family: Helvetica, Arial, sans-serif; font-size: 14px; margin-top: 6px;">
ink 1-4 gün ,</div>
</div>
<div>
<div style="background-color: white; color: #1d2129; display: inline; font-family: Helvetica, Arial, sans-serif; font-size: 14px; margin-top: 6px;">
küçük çocuklarda sık. hafif ateş, bulantı, kusma, ishalden sonra haftalara atılmaya devam eder.<br />süre 3-4 gün.</div>
</div>
Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-49181698525495542092020-03-17T01:58:00.001-07:002020-03-17T01:58:13.345-07:00CORONABULAŞMA YOLLARI
•<br />
Virüs, hasta bireylerden;<br />
➢ Öksürme ve hapşırma yoluyla ortaya saçılan damlacıklarla
veya<br />
➢ Hastaların kontamine ettiği yüzeylerden (göz, ağız, burun
mukozasına temasla) bulaşabilir<br />
➢ Cansız yüzeylerde 24 saat kadar canlı kalabilir<br />
➢ Güneş ışınlarına karşı duyarlıdır ..<br />
<br />
<br />
• Şu ana kadar yayımlanmış olan bilimsel yayınlara göre inkübasyon süresi 2 ile 27 gün
arasında bulunmuş olup, kabul edilen ortalama inkübasyon süresi 5 – 6 gündür.<br />
• COVID-19’un bulaştırıcılık süresi kesin olarak bilinmemektedir. Semptomatik dönemden
1-2 gün önce başlayıp semptomların kaybolmasıyla sona erdiği düşünülmektedir.<br />
Ortalama inkübasyon süresi 5 - 6 gündür.<br />
<br />
Hastalığın Klinik Özellikleri<br />
• Solunum semptomları; ateş, öksürük ve dispne başlıca
yakınmalardır<br />
• Daha ciddi vakalarda; pnömoni, ağır solunum yetmezliği,
böbrek yetmezliği ve hatta ölüm gözlenebilir<br />
• Asemptomatik kişilerin solunum yolunda virüsü taşıyabildiği
ve bunu çevrelerine de bulaştırabildiği bilinmektedir.<br />
<br />
PEDİATRIDUNYASI.ORGUzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-399258222364597742020-03-16T21:54:00.000-07:002020-03-16T21:54:11.624-07:00FİTOTERAPİ NOTLARIM <br />
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Fitoterapi:</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">PEDİATRİK
BİTKİ DOZLARI: çıkan kesir kaçta kaçının çocuğa
verileceğini gösterir.</span></div>
<ol>
<li><div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Clark
‘ s : kg X 2.2 / 150 </span>
</div>
</li>
<li><div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Young
‘s : yaş + 12 / yaş .</span></div>
</li>
</ol>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<br />
<br />
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Genel
pediatri klavuzlarında küçük çocuklar için yetişkin dozunun
1/ 3 ü . buyuk çocuklarda 1/2 si önerilir..</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<br />
<br />
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<br />
<br />
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;"><b>Matricaria
recutita: tıbbi papatya</b></span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Çiçekleri:
öksürük kesici, ateş düşürücü, antiinflamatuvar, ÜSYEde ,
GIS in inflamatuvar hastalıkları, haricen deri ve muköz membran
enfeksiyonları ,ağız ve boğaz infeksiyonları , jinjivit. yara
ve yanık iyileştirici..</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">y.e
: anaflaktik reaksiyon ,kontakt dermatit </span>
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">antikoagulanlarla
ve benzodiazepin grubu ile kullanılmamalı.</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Dahilen
: 3 gr. bitki üzerine 150 ml kaynar su, 5-10 dakika bekleyip
süzülür. Çocuk dozu erişkin doz üzerinden hesaplanır. </span>
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Haricen:
2 cay kaşığı drog üzerine 1 fincan sıcak su dökülür. Kapalı
halde 15 dakika bekletilip süzülür.</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Banyo
: 50 gr . bitki 10 litre sıcak suya eklenir.</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">İnhalasyon:
6 gr. kuru toz 1litre sıcak suya eklenir.</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Tentür
(1:5g/ml) 15 cc 3 kere/gün</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Hemoroidte
kulanım: bir su kabı içine sıcak su konur; 2-3 tutam pataya
ciceği atilir. Sıcak iken oturma banyosu yapılır. Sabah-aksam </span>
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">(Bitkiler
ile tedavi Prof. T. Baytop sy: 311) </span>
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Herbal
medicine 2000 sy: 57</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">FFd
monografları 2017 sy: 669</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<br />
<br />
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;"><b>Calendula
officinalis: aynısefa bitkisi</b></span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Mukoz
membran enfeksiyonu, peptik ülser, KC dalak inflamasyonları, GIS
spazmı, deri mukoza inflamasyonu, yara, yanık kesikler, bacak
ülserleri</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Boğaz
ağrısı için çay şeklinde: çiçekleri 1-2 gr. 150 ml sıcak
suda infuzyon 10-15 dakika demle,</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<a href="https://www.blogger.com/null" name="_GoBack"></a>
<span style="font-size: small;">Ülser için 1-4 gr. 150 ml.
Sıcak suda 10-15 dakika demle. X 2-3 kez</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Tentür:
1:5 ( gr/ml) 5-10 cc/gün</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Sıvı
extre 1:1 (gr/ml) 1-2 cc/gün</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Yara
tedavisinde kompres: bir yemek kasığı bitki 500 cc de 10-15 dakika
demlenir. </span>
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Herbal
medicine 2000 sy: 44</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">FFd
monografları 2017 sy: 199</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<br />
<br />
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;"><b>Ceratonia
siliqua: keçiboynuzu</b></span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Göğüs
yumuşatıcı, balgam söktürücü, bronş açıcı, kuru bitkisi
çocuk ishallerinde, </span>
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Akut
beslenme bozukluklukları , enterokolit, ishal, çölyak
,hazımsızlık, ayrıca saç dökülmesinde</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Dekoksiyon
%5 lik.</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">20-30
gr tozu günlük su, süt gibi içeceklere konarak tüketilir.</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Antiviral
etkilidir. Meyvesininin suyu siğil tedavisinde
kullanılır.(Ethnopharmacol. 2012; 141, p:1021-1040 ) </span>
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">PDR
for herbal medicine 2004</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">FFD
monografları 2017 sy 244</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<br />
<br />
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Bebeklere
glütensiz ekmek hazırlamak için 2 gr. 1 litre suya katarak
hazırlanır.</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Çocuklarda,
bakteri ve virüs kaynaklı diyarede, keçiboynuzu unu ve pekmezinin
kullanımının diyare süresini kısalttığı tespit edilmiştir.
(Journal of Pediatric Gastroenterology and Nutrition [01 May 1989,
8(4):480-485] )</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<br />
<br />
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;"><b>Melisa
officinalis:</b></span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Fonksiyonel
GIS bozuklukları, sinirsel uyku problemleri, huzursuzluk , asabiyet,
ÜSYE, astım, migren, </span>
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Fenobarbütallerin
etkisin arttırır.</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Extrenal
kullanım herpes labialiste etkili (Phytomedicine. 1999
Oct;6(4):225-30.) </span>
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">1,5
– 4,5 gr/ 150 cc infuzyon 2x1</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Sıvı
extre 1-4 cc / gün(1:1 %45 alkol)</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Tentür:
2-6 cc / gün x3 </span>
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">Herbal
medicine 2000 sy: 230</span></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<span style="font-size: small;">FFd
monografları 2017 sy: 703</span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;"><b>aloe
vera: </b></span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;">cilt
hastalıkalrında</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;">jeli:
küçük kesiler yanıklar , sıyrıklar, deri üleri , deri ,ltihabı
,sedef, seboriek egzema</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;">nemlendirme
ve yumusatma özelliği vardır.</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;">iltihabi
barsak hast, 12 yas altı, gebede kullanılmaz. 1-2 haftadan uzun
kullanılmaz.</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;">topikal
kullanımda tyaprak extreleri antrakinon içeridigi için nUV işığa
duyarlılığı arttırır.</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;">FFD
monografları sy.60</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<br />
</div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;"><b>calendula
officinalis:</b></span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;">1-yara
yeri kompres için: </span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;">1
yemek kasığı bitki 500 cc suda 10-15 dakika demlenir.
nemlemdirici olarak etkilenen bolgeye uygulanır.</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;">2-
boğaz ağrıs için çay: 2 gr /150 cc kaynar su 10 -15 dakika
demle.</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;">FFD
monografları sy.200</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<br />
</div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;"><b>camelia
sinensis</b></span><span style="font-family: Calibri, serif;">:</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;">kurutulmus
yaprakları infuzyon, dekoksiyon seklinde antioksidan
antienflmatuvar ,antimiktobiyal...</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;">DM
HT ve KC hast.da dikkatli kullanılmalı.</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;">gebede
2 fincandan fazla tuketilmemeli.</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;">2
gr .cay yapragı 3-10 dakika kaynayan suda demlenir. </span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;">gunde
3 fincandan fazla yeşil çay tuketilmemeli..</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;">FFD
monografları sy.210.</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<br />
</div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Times New Roman, serif;"><span style="font-size: small;"><span style="font-family: Calibri, serif;"><b>Reçete
ornekleri.</b></span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<br />
</div>
<div style="background: #ffffff; line-height: 100%; margin-bottom: 0cm;">
<span style="color: #1d2129;"><span style="font-size: small;">1.
derecede yanık:</span></span></div>
<div style="background: #ffffff; line-height: 100%; margin-bottom: 0cm;">
<span style="color: #1d2129;"><span style="font-size: small;">tibbi
papatya infuzyonu. 1 bardak kaynar suya 2 gr. matricaria agzı kapalı
demlenir .soguyunca yanık bolgesine pansuman yapılır..</span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<br />
</div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="color: #1d2129;"><span style="font-size: small;"><span style="background: #ffffff;">2-
soğuk algınlıgında:</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="color: #1d2129;"><span style="font-size: small;"><span style="background: #ffffff;">bır
bardak kaynar suya 2 gr ıhlamur ciceği agız kapalı 5 dakika
demle. içilir.</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<br />
</div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="color: #1d2129;"><span style="font-size: small;"><span style="background: #ffffff;">3-
tasıt tutmasında .</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="color: #1d2129;"><span style="font-size: small;"><span style="background: #ffffff;">0.5-
1 gr zencefil rizomları dekoksıyon seklinde. soguk suya konup
kaynamaya baslayınca 5 dakika daha kısık ateste kaynatılıp
soguyunca içilir.</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<br />
</div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="color: #1d2129;"><span style="font-size: small;"><span style="background: #ffffff;">4-
kardiyak etkili:, poziitf inotropik etki, </span></span></span>
</div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="color: #1d2129;"><span style="font-size: small;"><span style="background: #ffffff;">alıç
1.5 gram drog infüzyon seklinde 150 cc kaynamıs suda 5 dakika agzı
kapalı .</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="color: #1d2129;"><span style="font-size: small;"><span style="background: #ffffff;">gunde
3 kere.</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<br />
</div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="color: #1d2129;"><span style="font-size: small;"><span style="background: #ffffff;">5-
diüretik etki için:</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="color: #1d2129;"><span style="font-size: small;"><span style="background: #ffffff;">ısırgan
otu toprak üst kısmı 2 gr drog 150 cc kaynamıs suda 10 dakika
beklet.gunde 3 kez.</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="color: #1d2129;"><span style="font-size: small;"><span style="background: #ffffff;">ısırganın
kökü ise aynı sekilde hazırlanır.selim prostat hipertofisinde
kullanılır.</span></span></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<br />
</div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<br />
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<b>Passiflora:</b></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
Toprak üstü
kısımları uykusuzuk, huzursuzkluk, endişe, premensruelsendrom
,gerginlik te dahilen kull.</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
Tek basına ya da
valeriana, melissa ile t tb surup formları bulunur.</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
Barbituratlarla
etkilesir. MAO inh ile kullanılmaz..</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
Günde 3-4 defa 2
gr. infuzyon,
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
1-4 cc (1:8)
tentür
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
3-12 yas
cocuklarda doz ayarlanarak .</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<br />
<br />
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<b>Cinnamomum
verum . seylan tarçını:</b></div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
Grip, kurt
düşürücü, mide bulantısı kusma,</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
Drog tek seferde
1 gr günlük 4 gr max.</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
Sıvı exrte (1:1
g/ml) %70 etanol 1cc / gün x3</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
Tentür (1:5 g/m)
3-6 cc/gün x3
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
Emenagog etkili.
Gebede kullanılmaz</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
Ülserde
kullanılmaz,</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<br />
<br />
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<br />
<br />
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<br />
<br />
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<br />
<br />
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<br />
<br />
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<br />
<br />
</div>
<div style="line-height: 108%; margin-bottom: 0.28cm;">
<br />
<br />
</div>
<br />Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-44169622858619487652020-03-13T03:17:00.002-07:002020-03-13T03:17:25.236-07:00YD a verilecek mama <div>
<br /></div>
<div>
<br /></div>
İlk 24 saat 2-10 ml<div>
<br /><div>
24-48 saat 5-15 ml </div>
<div>
<br /></div>
<div>
48-72 saat 15-30 ml </div>
<div>
<br /></div>
<div>
72-96 saat 30-60 ml</div>
</div>
Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-14034536020829849832020-03-12T07:16:00.000-07:002020-03-13T01:53:16.396-07:00pubertakızlarda meme gelişimi Tanner evre 2 : normali 10.5 yas,..... alt sınır 8 yas<br />
erkekte testis volum genişlemesi : normali 11.5 yas ,...... alt sınır 9 yas<br />
pubarj evre 2 : 11 -12 yas, ....alt sınır kız 8 yas erkek 9 yas<br />
telarj normali >9 yas ..........erken <9 yas<br />
mernarş erken < 10 yaş.<br />
<br />
<br />
pubertada boy kazanımı:<br />
kız: 16-20 cm<br />
erkek: 24-28 cmUzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-10111704259496719042020-03-12T05:37:00.000-07:002020-03-13T03:12:53.282-07:00İYEidrar yolu enfeksiyonu için<br />
<br />
torba idrarı: 100.000<br />
clean voided 10.000 ( + semptom varsa)<br />
katerer 1.000<br />
suprapubik aspirat 1.Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-49786949569618093012020-03-12T05:27:00.000-07:002020-03-13T02:08:22.832-07:00sorularbebeklerin gündüz bulunduğu ortama ısısı 22 - 24 C olmalı.<br />
gece ısısı 20 - 22 C olmalı. gece uyudugu oda isisi >24 C olursa ani bebek ölümü riski artar. .<br />
gece ısı artarsa sıcak hava mukozayı kurutur .,miktoplara duyarlı hale getirir.<br />
<br />
ilk 6 ayda bebeğin anneyle aynı odada ama kendi yatagında yatması ABÖS korur.<br />
ilk 1 yasta yastık onerilmez.<br />
bebekler her gun yıkanabilir ama haftada 2 kere sampuan kullanılmalı.<br />
<br />
<a href="http://37.247.97.7/milli_pediatri_2019/player.php?klasor_no=201902011031">http://37.247.97.7/milli_pediatri_2019/player.php?klasor_no=20190211031</a><br />
<br />
<br />Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-43986426189463929672020-03-10T07:44:00.000-07:002020-03-13T03:51:23.360-07:00#AROMATERAPİKORTİZOL SEVİYESİNİ DUSÜREN E Y. :<br />
<br />
LİMON<br />
PETİTGRAİN<br />
BERGAMOT<br />
FRANK.<br />
NANE<br />
CLARY SAGE<br />
<br />
<br />
çocuklarda güvenli anitiviral e.y:<br />
nane<br />
paculi<br />
selvi,<br />
nioli<br />
<br />
antiviral ozeliklikli:<br />
selvi<br />
paculi<br />
okaliptus<br />
limon<br />
nane<br />
lavanta<br />
palmaroza<br />
cloveUzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0tag:blogger.com,1999:blog-8849287830739189580.post-27721429925919462752020-03-09T13:36:00.001-07:002020-03-13T05:17:40.275-07:00HÜSHÜS temel olarak mikroanjiopatik hemolitik anemi, trombositopeni,akut böbrek yetmezliği ile karakterize klinik bir tablodur.<br />
Hastaların %90 ında klinik tablodan diyareye yol açan Shiga toksin üreten E.coli
sorumludur.<br />
HÜS tipik ve atipik olarak ayrılır.<br />
Tipik HÜS çocuk çağı HÜS’lerin %90 ından sorumludur.(insidansı2-3/100.000) en sık etken EHEC(%70)(en sık serotip:O157:H7).<br />
Çocuklarda ABY nin en sık nedenidir.<br />
Atipik HÜS: alternatif kompleman yolunun kontrolsüz aktivasyonu sonucu ortaya çıkar.<br />
<br />
Klinik bulgular.:
olguların çoğunda , hastalığı tetkikleyici olarak akut üst solunum yolu enfeksiyonu ve akut ishal gibi
enfeksiyon vardır.<br />
Halsizlik, huzursuzluk,beslenememe,bulantı,karın ağrısı,kusma,kanlı ishal,idrar miktarında azalma, kanlı idrar yapma,MSS tutulumuna bağlı laterji,irritabilite ve nöbet izlenebilir.<br />
<br />
Atipik HÜS
tedavide ilk olarak destek tedavisi , plazma tedavisi ,Equlizumab, böbrek-karaciğer nakli,immunsupresi
tedavi kullanılabilir.Uzm.Dr. Nevin KURThttp://www.blogger.com/profile/17714544049440203827noreply@blogger.com0