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Yıl:2010; Cilt: 20; Sayı: 3>> Özet
TAM METİN
Klinik Psikofarmakoloji Bülteni; 2010;20(3):255-257
Tıbbi endikasyon olmadan fentanil kullanımı sonrası gelişen bağımlılık: Bir olgu sunumu
O Gecici, Z Gokmen, M Nebioglu
Akdeniz Üniversitesi Tıp Fakültesi Psikiyatri Anabilim Dalı Antalya
Fentanil pür ve selektif opioid µ reseptör agonisti olup morfinden 80-100 kat daha potent analjezik etkiye ve daha az yan etkiye sahiptir. Türkiye'de tek form olarak bulunan transdermal bant konsantrasyonları 2.5, 5, 7.5, 10 mg fentanil içerip 72 saat boyunca 25-100 mcg /saat dozlarında salınmaktadır. Son yıllarda bu kötüye kullanım gittikçe artmaktadır. Fentanil transdermal bantları tedavi amaçlı kullanan populasyon haricinde, kötüye kullananlarda bant içeriğinin intavenöz enjeksiyonu, oral-transmukozal uygulanım, rektal kullanım ve inhalasyon yolu ile alımı bildirilmiştir. Literatürde yurt dışından çok sayıda vaka bildirimleri bulunmasına rağmen, bunların hepsi ya kötüye kullanım ya da yanlış kullanım sonrası fentanile bağlı gelişen komplikasyonlarla ilgilidir. Tartışacağımız vaka Türkiye'de n ilk defa bildirilmesi ve bir fentanil bağımlılığı olması nedeniyle önem kazanmaktadır. 59 yaşında bir erkek tıbbi endikasyon olmaksızın fentanil transdermal bantları kullanmış ve bağımlılık gelişmiştir. Literatürde fentanilin bir opioid reseptör agonisti olarak daha çok kötüye kullanımı bildirilmiş olsa da bağımlılık açısından da dikkatle ele alınması gereklidir.
Fentanyl dependence caused by the non-medical use: a case report
Fentanyl is a pure and selective μ opioid receptor agonist. Its analgesic potency is 80-800 times greater than that of morphine with fewer adverse effects. Available formulations of fentanyl patches in Turkey contain 1.25, 2.5, 5, and 7.5 mg or 10 mg of fentanyl and provide a dose of 12.5?100 lg⁄h for up to 72 h. Abuse of fentanyl patches has been increasingly reported along with different routes of administration such as oral-transmural, intravenous, inhalation, and rectal use. There are many case reports about complications of fentanyl patches because of misuse or abuse. However, this is the first case from Turkey reporting fentanyl dependency in a 59 [year] old male patient, who had started to use fentanyl without any medical indication. Although abuse of fentanyl is commonly reported, patients should be carefully scrutinized for fentanyl dependence as well.

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