EFFECTIVINESS OF AMANTADINE FOR SEVERE TRAVMATIC BRAIN INJURY: CASE SERIES AND LITERATURE REVIEW

Yıl 2022, Cilt: 29 Sayı: 3, 510 - 514, 30.09.2022

Pınar Karabacak , Özlem Polat

https://doi.org/10.17343/sdutfd.1057423

Öz

Traumatic brain injury (TBI) is the most common cause
of death among young population. Approximately
10-15% of these patients, are associated with many
severe comorbid conditions, are discharged in
vegetative state. Amantadine acts as both a NMDA
receptor antagonist and an indirect dopamine agonist.
But its exact mechanism of action is still unknown. It
is frequently use to increase alertness in patients with
TBI. In this presentation, we aimed to present the eight
cases with TBI which were treated with Amantadine
in İntensive Care Unit (ICU). The characteristics of
the cases are given in Table 1. All of patients with
traumatic brain injury were intubated and unconscious
upon arrival. We used Thiopental sodium for sedation
to all patients. Amantadine sulfate treatment was
started in the first hour as 200 mg / day and treatment
was continued for at least 10 days.
Traumatic brain injury (TBI) are serious health
problems with social and economic consequences.
Although there are many methods for to increase
neurological recovery, there is still no specific
treatment. Amantadine is a reliable and frequently
used drug for to improve the neurological recovery
of the patients with TBI. In the literature, the
studies on the use of amantadine in patients with
TBI was compared with the control group and
various parameters. These studies were shown that
neurological recovery was better in the amantadine
group. We used some variables such as Glasgow
Coma Scale (GKS), Full Outline of Unresponsiveness
(FOUR) scale and duration of stay at ıcu and hospital.
FOUR scale are better reflects the neurological status
in intubated patients. Although there are a limited
number of articles indicating efficacy, new studies on
amantadine use, dose, and duration are needed in
patients with TBI.

Anahtar Kelimeler

Amantadine, Neurological Recovery, Severe Travmatic Brain Injury

CİDDİ TRAVMATİK BEYİN HASARINDA AMANTADİN ETKİNLİĞİNİN DEĞERLENDİRİLMESİ: OLGU SERİSİ VE LİTERATÜR DERLEMESİ

Öz

Travmatik beyin hasarı (TBH) genç nüfus arasında
sık görülen bir ölüm sebebidir. Bu hastaların yaklaşık
% 10-15'nde ciddi komorbiditeler görülmektedir ve vejetatif
bir hayat ile taburcu edilmektedirler. Amantadin,
NMDA (N-metil-D-aspartat) reseptör antagonisti ve
indirekt dopamin agonisti gibi davranmaktadır. Fakat
etki mekanizması net değildir. TBH olan hastalarda
uyanıklığı artırmak için hala kullanılmaktadır. Bu olgu
serisinde, TBH ile yoğun bakımda takip edilen ve tedavilerinde
amantadin kullanılan 8 hasta sunulmuştur.
Olguların özellikleri Tablo 1'de verilmiştir. Travmatik
beyin hasarı olan tüm hastalar geldiklerinde bilinçsizdi
ve entübe edildiler. Tüm hastalara sedasyon için tiyopental
sodyum 3 mg/kg yükleme sonrası 3-5 mg/ kg /
saat infüzyon dozlarında kullanıldı. Amantadin sülfat
tedavisine ilk saatte 200 mg / gün olarak başlandı ve
tedaviye en az 10 gün devam edildi. Travmatik beyin
hasarı (TBI), sosyal ve ekonomik sonuçları olan ciddi
bir sağlık problemidir. Nörolojik iyileşmeyi artırmak
için pek çok yöntem bulunmasına rağmen hala spesifik
bir tedavisi yoktur. Amantadin, TBH'li hastaların
nörolojik iyileşmesi için güvenilir ve sıklıkla kullanılan
bir ilaçtır. Literatürde TBH'li hastalarda amantadin
kullanımına ilişkin çalışmalar kontrol grubu ve çeşitli
parametreler ile karşılaştırılmıştır. Bu çalışmalar,
amantadin grubunda nörolojik iyileşmenin daha iyi
olduğunu göstermiştir. Glasgow Koma Ölçeği (GKS),
Full Outline of Unresponsiveness (FOUR) skalası ve
yoğun bakım ve hastanede kalış süresi gibi bazı değişkenler
kullandık. FOUR skalası entübe hastalarda
nörolojik durumu daha iyi yansıtır. Etkinliği gösteren
sınırlı sayıda makale olmasına rağmen TBH'li hastalarda
amantadin kullanımı, dozu, süresi ile ilgili yeni
çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Amantadin, Nörolojik İyileşme, Şiddetli Travmatik Beyin Hasarı

Kaynakça

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