NEUTROPENIJA IZAZVANA LEKOVIMA KOJI NISU CITOSTATICI

Slobodan M Janković

doi:10.5937/racter8-9675

Slobodan M Janković Univerzitet u Kragujevcu, Fakultet medicinskih nauka

DOI: https://doi.org/10.5937/racter8-9675

Ključne reči: neutropenia||, ||neutropenija, drugs||, ||lekovi, causal relationship||, ||uzročno-posledična veza,

Sažetak

Polimorfonuklearni neutrofili čine oko 60-70% svih leukocita kod odraslih. Pod neutropenijom se podrazumeva broj neutrofila < 1500 ćelija/mm³. Neutropenija se može podeliti na blagu, umerenu i tešku, na osnovu apsolutnog broja neutrofila: 1000-1500 ćelija/mm³, 500-1000 ćelija/mm³, i <500 ćelija/mm³. Incidencija neutropenije izazvane lekovima je oko 3-10 slučajeva na milion stanovnika.

Neutropenija izazvana lekovima nastaje brzo, i razvija se posle nekoliko sati do 1-2 dana od primene leka. Do sada je opisano nekoliko mehanizama nastanka neutropenije izazvane lekovima koji nisu citostatici: (1) vezivanje leka za membranu ćelije, nastanak haptena i stimulacija imunog odgovora koji razara neutrofile; (2) izazivanje apoptoze neutrofila; (3) stvaranje imunih kompleksa, koji se vezuju za neutrofile i izazivaju njihovu destrukciju; (4) indukcija nastanka autoantitela i aktivacija komplementa, koji dovodi do lize neutrofila; (5) dozno-zavisna inhibicija granulopoeze; i (6) direktan toksični efekat na mijeloidne prekursore.

Tretman pacijenata kod kojih nastane neutropenija podrazumeva prekid primene leka koji ju je izazvao, održavanje striktne higijene i primenu faktora stimulacije granulocitnih kolonija kod teškog oblika neutropenije.

Biografija autora

Slobodan M Janković, Univerzitet u Kragujevcu, Fakultet medicinskih nauka

Redovni profesor Farmakologije i toksikologije i Klinicke farmacije

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