
Neželjeni efekti ljekova, ili kako se u literaturi često može naći nuspojave, karakterišu svaku štetnu i neželjenu reakciju lijeka koji je primijenjen na ispravan način i u propisanoj dozi. To je, u većini slučajeva, očekivana pojava koja se istražuje i prati, i priložena je u uputstvu koji se nalazi u kutiji lijeka. Ponekad je ta lista neželjenih efekata proširena, toliko detaljno opisana da osoba koja koristi lijek dolazi u dilemu da li da uopšte koristi prepisani lijek i ima li on više štetnih efekata nego koristi.
Često, pored propisanih ljekova, uzimamo i čaj, herbalni preparat ili dodatak prehrani, te je važno znati da i oni u velikoj mjeri mogu uticati na pojavu neželjenog djelovanja lijeka. Naime, nekada se mogu javiti nuspojave samo u kombinaciji s drugim preparatom, pa takve faktore treba izbjeći.
Prema mehanizmu nastanka, neželjeni efekti su prvobitno bili podijeljeni u tip A i B, zatim prošireni na C, da bi danas postojalo 5 tipova.
– Tip A karakterišu dozno zavisne reakcije koje su uglavnom predvidljive i posljedica su farmakološkog djelovanja lijeka.
– Tip B karakterišu pojave koje nisu dozno zavisne, često nepredvidljive, i najbitnije je da nisu u vezi sa farmakološkom aktivnošću lijeka.
- Tip C je dozno zavisna pojava. Karakteriše ga tačno predviđeno vrijeme pojave simptoma i ovo je obično posljedica kumulativnog efekta samog lijeka.
– Tip D je neuobičajena reakcija samog organizma na lijek. Često se ispoljava tek nakon određenog vremena i nije dozno zavisan.
– Tip E karakterišu sva ona neželjena djelovanja koja
nastaju nakon prekida terapije, tako da je potrebno ponovo uvesti upotrebu lijeka i postupno smanjivati dozu do potpunog prestanka.
Naučna disciplina koja se bavi prikupljanjem, obradom i informisanjem o neželjenim djelovanjima ljekova naziva se farmakovigilanca. Spontana prijavljivanja vrše zdravstveni radnici čija je moralna i profesionalna odgovornost da svaku sumnju prijave nadležnoj ustanovi. Obavezno prijavljivanje neželjenih efekata lijeka imaju nosioci dozvole za stavljanje lijeka u promet.
U Crnoj Gori, Agencija za lijekove i medicinska sredstva – CALIMS, bavi se prikupljanjem i obradom svih pristiglih primjedbi na reakciju na neki lijek. Ona izdaje godišnji izvještaj o rezultatima prijavljivanja neželjenog djelovanja na lijek koji se dalje prosljeđuje u Centar za monitoring u Upsali (Švedska).
PREPORUKE
Smanjenju učestalosti neželjenih efekata ljekova na organizam veliki doprinos mogu dati sami zdravstveni radnici, što kroz prijavljivanje svakog nepoželjnog efekta, to i kroz kontinuiranu edukaciju pacijenata o pravilnoj primjeni lijekova izdatih na recept, te i OTC preparata. Ostale preporuke su:
– Lijek ne propisivati osobama koje imaju predispoziciju za pojavu neželjenih efekata (genetskih ili alergijskih).
– Uvijek koristiti najmanju moguću dozu koja ima zadovoljavajući efekat.
– Lijek uvijek aplicirati optimalnim putem.
– Kada god je moguće, razviti podesne farmaceutske oblike koji pokazuju najblaži neželjeni efekat.
– Interakcije sa drugim lijekovima svesti na najnižu moguću mjeru, naročito sa herbalnim preparatima, vitaminima i mineralima koji se najčešće koriste bez nadzora ljekara ili farmaceuta.
– Obavezno obavijestiti pacijenta o mogućim neželjenim efektima koji se mogu očekivati tokom upotrebe lijeka, kao i o mjerama koje treba preduzeti ukoliko se ti efekti pojave.
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