Metaboličke nuspojave lijekova

master's thesis

• Title (english): Metabolic side-effects of drugs
• Author: Ian Bičanić
• Mentor: Lidija Bach-Rojecky (mentor)
• Committee member: Lidija Bach-Rojecky (predsjednik povjerenstva)
• Committee member: Sanda Vladimir-Knežević (član povjerenstva)
• Committee member: Iva Mucalo (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of pharmacology); Zagreb
• Defense date and country: 2022-06-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Metabolički sindrom je definiran kroz prisutnost barem tri od pet poremećaja: pretilost centralnog tipa,
hipertrigliceridemija, nizak HDL-C, hipertenzija i hiperglikemija natašte.
Mehanizmi koji dovode do nastanka metaboličkog sindroma nisu potpuno jasni. Vjerojatno je riječ o složenom
međudjelovanju Različitih endogenih i egzogenih promjenjivih i nepromjenjivih čimbenika rizika, a određene skupine
lijekova su jedan od njih. Metaboličke nuspojave lijekova značajno doprinose razvoju metaboličkog sindroma,
stvarajući tako nove zdravstvene poteškoće, što neposredno utječe na adherenciju i učinkovitost propisane terapije.
Među lijekovima koji izazivaju metaboličke nuspojave najzastupljeniji su lijekovi iz skupine antipsihotika, a značajan
utjecaj na metabolički profil pacijenta ostvarili su i određeni lijekovi iz skupina antiepileptika, kortikosteroida
(glukokortikoida), inhibitora proteaze te antihipertenziva (tiazidni diuretici i beta-blokatori). Učestalost i intenzitet
metaboličkih nuspojava varira između pojedinih skupina lijekova, kao i između lijekova unutar svake od rizičnih
skupina. Kada god je moguće, preporuča se odabir lijeka s povoljnijim utjecajem na metabolički status, posebice kod
visokorizičnih pacijenata koji imaju i druge predispozicije za razvoj metaboličkog sindroma. U nedostatku
učinkovitijih terapijskih opcija, odnosno kada je terapija određenim lijekom nužna, a omjer koristi i rizika prihvatljiv,
metaboličke nuspojave nastoje se maksimalno ublažiti kombinacijom redovitog praćenja ključnih metaboličkih
parametara i prilagodbom doze lijeka, promjenom životnih navika te u konačnici uvođenjem terapije za smanjenje
negativnih posljedica farmakoterapije na pacijentovo zdravlje.

Abstract (english)

The metabolic syndrome is defined by the presence of at least three of five disorders: central obesity,
hypertriglyceridemia, low HDL-C, hypertension, and fasting hyperglycemia.
The mechanisms leading to the development of the metabolic syndrome are not completely understood. The metabolic
syndrome is probably a consequence of complex interactions of the primary disease, the pharmacological properties of
the drug (s) and a number of other variable and invariant risk factors. Metabolic side effects of drugs significantly
contribute to the development of metabolic syndrome, thus creating new health problems, which directly affects the
adherence and effectiveness of prescribed therapy. Among the drugs that cause metabolic side effects, the most
significant metabolic influence is attributed to the drugs from the group of antipsychotics, but a less prominent, yet
significant impact on the metabolic profile of the patient can also be found in certain drugs from the groups of
antiepileptics, corticosteroids (glucocorticoids), protease inhibitors and antihypertensives (thiazide diuretics and betablockers).
The frequency and intensity of metabolic side effects varies between groups of drugs, as well as between
drugs within each of the risk groups. Whenever possible, it is recommended to choose a drug with a more favorable
effect on metabolic status, especially in high-risk patients who have other drug-related predispositions which
additionally increase the risk of developing the metabolic syndrome. In the absence of more effective treatment
options, ie. when therapy with a particular drug is necessary and the benefit-risk ratio is acceptable, metabolic side
effects are minimized by combining continuous monitoring of key metabolic parameters, adjusting drug dosage,
changing lifestyle habits and ultimately introducing therapy to reduce the negative effects of pharmacotherapy on the
patients metabolism and to prevent potential complications to the patient's health.

• Keywords: antipsihotici; antiepileptici; glukokortikoidi; hiperglikemija; povećanje težine; hiperlipidemija; nuspojave
• Keywords (english): antipsychotics; antiepileptics; corticosteroids; hyperglicemia; hyperlipidemia; weight gain; adverse effects
• Language: croatian
• URN:NBN: urn:nbn:hr:163:502444
• Study programme: Title: Pharmacy; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-07-05 11:54:00