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Lyfjameðferð gláku og hugsanlegar milliverkanir við meðferð annarra sjúkdóma

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Authors
Valgerður Dóra Traustadóttir
Elín Björk Tryggvadóttir
Ólöf Birna Ólafsdóttir
Aðalsteinn Guðmundsson
María Soffía Gottfreðsdóttir
Issue Date
2019-04

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Other Titles
Medical management of glaucoma and interaction between glaucoma and systemic medications
Citation
Lyfjameðferð gláku og hugsanlegar milliverkanir við meðferð annarra sjúkdóma. 2019, 105(4): 163-69
Abstract
Inngangur: Gláka er alvarlegur augnsjúkdómur og var algengasti blinduvaldur á Íslandi fram á miðja síðustu öld. Þar sem tíðni gláku hækkar með aldri eru sjúklingar með gláku oft einnig með aðra sjúkdóma og á margs konar lyfjum. Mikilvægt er að hafa gláku í huga þegar lyfjameðferð þessara sjúklinga er ákveðin þar sem augndropameðferð og lyf til inntöku geta haft milliverkanir og aukaverkanir sem skipta sköpum fyrir öryggi og líðan. Markmið rannsóknarinnar var að kanna lyfjameðferð sjúklinga með langt gengna gláku. Aðferðir: Fram fór afturskyggn rannsókn þar sem skoðuð voru gögn 100 einstaklinga sem gengust undir fyrstu hjáveituaðgerð við gláku á Landspítala árin 2013-2017. Skráð voru lyf til inntöku á 6 mánaða tímabili fyrir og eftir aðgerð, glákumeðferð fyrir aðgerð, helstu sjúkdómsgreiningar ásamt aldri og kyni. Niðurstöður: Meðalaldur við aðgerð var 75 ár og voru 53 konur í hópnum. Af 100 sjúklingum voru 87 á lyfjum við öðrum sjúkdómum og meðalfjöldi lyfja til inntöku var 5,3 lyf á mann. Meðalfjöldi augnþrýstingslækkandi lyfja var 3,0 á mann. Prostaglandín-hliðstæður voru algengasta augnþrýstingslækkandi lyfið. Algengasti lyfjaflokkurinn vegna annarra sjúkdóma var blóðþrýstingslækkandi lyf sem 57 sjúklingar tóku að staðaldri, þar af voru 30 sjúklingar á beta-blokkum. Zópíklón var algengasta einstaka lyfið, 29 sjúklingar tóku það. Ályktun: Sjúklingar með gláku taka ýmis lyf vegna annarra sjúkdóma sem geta haft áhrif á glákuna og milliverkanir við glákulyf. Þegar lyfjameðferð er ákveðin fyrir einstakling með gláku þarf að hafa í huga hugsanlegar milliverkanir annarra lyfja við gláku og hins vegar milliverkanir gláku­lyfja við aðra sjúkdóma.
Introduction: Glaucoma used to be the most common cause for blindness in Iceland. As the incidence of glaucoma increases with age, the patients often have numerous comorbidities and use various medications. It is important to keep in mind interactions and side effects of glaucoma medications when deciding systemic medical treatment for these patients to ensure their safety and comfort. The goal of the study was to gather information about drug use of patients with severe glaucoma. Methods: A retrospective study where data were collected from 100 consecutive patients who underwent a trabeculectomy as first glaucoma surgery at Landspitali National University Hospital of Iceland during 2013-2017. All systemic and ophthalmic medi­cations during 6 months before and after the surgery, medical diagnoses, age and gender of the patients were registered. Results: Of all 100 patients, 87 used systemic medication, averaging 5.3 drugs/patient. Mean number of glaucoma medi­cation used was 3.0. Mean age at surgery was 75 years and 53 were women. The most common systemic drug class was anti- hypertensives, used by 57 patients where beta-blockers were the most common, used by 30 patients. Zopiclone was the most common single drug, used by 29 patients. Conclusion: It is evident that patients with glaucoma take various drugs for systemic illness that can affect their glaucoma and have interactions with glaucoma drugs. It is urgent that healthcare providers keep this in mind when deciding on systemic treatment for patients with glaucoma, with regards to possible interactions with glaucoma drugs and the effect on patient's overall health.
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https://www.laeknabladid.is/tolublod/2019/04/nr/7020
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Icelandic Journal Articles (Peer Reviewed)

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