ANALISIS PENGGUNAAN OBAT PADA KOMPLIKASI SIROSIS HATI

https://doi.org/10.22146/jmpf.270

Yeni Farida(1*), Tri Murti Andayani(2), Neneng Ratnasari(3)

(1) 
(2) 
(3) 
(*) Corresponding Author

Abstract


Penatalaksanaan terapi sirosis hati bervariasi sesuai dengan komplikasi yang menyertai. Penelitian ini bertujuan untuk mengetahui gambaran penggunaan obat pada komplikasi sirosis hati dan membandingkan kesesuaiannya dengan standar pelayanan medik rumah sakit dan guideline Asia Pasific Ascociation Study for Liver (APASL). Penelitian ini merupakan penelitian observasional analitik dengan pengambilan data secara retrospektif. Subyek penelitian diperoleh dengan teknik purposive sampling dengan kriteria inklusi pasien dewasa dan rawat inap pada periode 2013. Data diperoleh dari rekam medik kemudian dianalisis dengan cara membandingkan kesesuaian pemberian obat dengan standar pelayanan medik rumah sakit dan guideline APASL. Subyek penelitian berjumlah 70 pasien dengan komplikasi utama hipertensi portal (varises esofagus) sebanyak 46 kasus, perdarahan 24 kasus, ascites 36 kasus, infeksi 28 kasus dan ensefalopati hepatik 24 kasus. Terapi utama hipertensi portal dengan propranolol, perdarahan dengan vitamin K, ascites dengan spironolakton dengan atau tanpa kombinasi furosemid, infeksi dengan sefalosporin generasi 3 dan quinolone, ensefalopati hepatik dengan laktulosa dengan atau tanpa neomisin, BCAA dan LOLA. Hasil penelitian menunjukan bahwa penanganan komplikasi sirosis hati di RSUP Dr. Sardjito belum semuanya sesuai dengan standar pelayanan medik rumah sakit dan guideline APASL. Pada kondisi pasien yang tidak mengalami perbaikan dengan terapi standar dilakukan modifikasi terapi seperti pada kasus perdarahan dengan menambahkan proton pump inhibitor (omeprazole, lansoprazol atau pantoprazol) dan asam traneksamat.

 

Kata kunci: pengobatan sirosis hati, komplikasi sirosis hati, standar pelayanan medik rumah sakit,


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References

American Thoracic Society dan Infectious Diseases Society of America, 2005. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. American journal of respiratory and critical care medicine, 171: 388–416.

Asia Pasific Ascociation Study for Liver, 2008. Primary prophylaxis of gastroesophageal variceal bleeding: consensus recommendations of the Asian Pacific Association for the Study of the Liver. Journal of Hepatology, 429-439.

Deshpande, A., Pasupuleti, V., Thota, P., Pant, C., Mapara, S., Hassan, S., dkk., 2013. Acid-suppressive therapy is associated with spontaneous bacterial peritonitis in cirrhotic patients: a meta-analysis. Journal of gastroenterology and hepatology, 28: 235–242.

Eom, C.-S., Jeon, C.Y., Lim, J.-W., Cho, E.-G., Park, S.M., dan Lee, K.-S., 2011. Use of acid-suppressive drugs and risk of pneumonia: a systematic review and meta-analysis. CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne, 183: 310–319.

European Association for the Study of the Liver, 2010. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis 53: 397 – 417.

Garcia, D., Quintana, J., Gonzalez, J.., dan Garza, H.., 2009. Liver cirrhosis and diabetes: Risk factors, pathophysiology, clinical implications and management. World Journal of Gastroenterology, 15: 280–288.

Guglielmo, J., 2013. Principles of Infectious Diseases, dalam: Applied Therapeutic The Clinical Use of Drugs. Wolter Kluwers, Lippincott.

Hidaka, H., Nakazawa, T., Wang, G., Kokubu, S., Minamino, T., Takada, J., dkk., 2012. Long-term administration of PPI reduces treatment failures after esophageal variceal band ligation: a randomized, controlled trial. Journal of gastroenterology, 47: 118–126.

Kemenkes, 2013. Implementasi Formularium Nasional Dalam Pelaksanaan Pelayanan Kesehatan Di Fasilitas Kesehatan Rujukan.

Kumada, H., 2002. Long-Term Treatment of Chronic Hepatitis C with Glycyrrhizin [Stronger Neo-Minophagen C (SNMC)] for Preventing Liver Cirrhosis and Hepatocellular Carcinoma. Oncology, 62: 94–100.

Koulaouzidis, A., Bhat, S., dan Saeed, A.A., 2009. Spontaneous bacterial peritonitis. World Journal of Gastroenterology: WJG, 15: 1042–1049.

Kusumobroto, H., 2007. Sirosis Hati, dalam: Buku Ajar Ilmu Penyakit Hati Edisi I. FK Universitas Indonesia, Jakarta.

Mandell, L.A., Wunderink, R.G., Anzueto, A., Bartlett, J.G., Campbell, G.D., Dean,

N.C., dkk., 2007. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America, 44 Suppl 2: S27–72.

Malaguarnera, M., Risino, C., Cammalleri, L., Malaguarnera, L., Astuto, M., Vecchio, I., dkk., 2009. Branched chain amino acids supplemented with L-acetylcarnitine versus BCAA treatment in hepatic coma: a randomized and controlled double blind study. European journal of gastroenterology & hepatology, 21: 762–770.

Perz, J.., Armstrong, G.., Farington, J.., Hutin, J.., dan Bell, B.., 2006. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. Journal of Hepatology, 45: 529–538.

Riwidikdo, H., 2009. Statistika Kesehatan. Mitra Cendekia Press, Yogyakarta.

Senzollo, M., Burra, P., Cholongitas, E., dan Burroughs, A., 2006. New insights into the coagulopathy of liver disease and liver transplantation. World Journal of Gastroenterology, 12: 7725–7736.

Shiha, G., Sarin, S.K., Ibrahim, A.E., Omata, M., Kumar, A., dan Lesmana, L.., 2009. Liver fibrosis: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL). International Journal of Hepatology, 3: 323–333.

Simonetto, D.A., Shah, V.H., dan Kamath, P.S., 2014. Primary Prophylaxis of Variceal Bleeding. Clinics in liver disease, 18: 335–345.

Tarigan, P., 2007. Ensefalopati Hepatik, dalam: Buku Ajar Ilmu Penyakit Hati Edisi I. FK Universitas Indonesia, Jakarta.

Tasnif, Y. dan Hebert, M., 2013. Complications of End-Stage Liver Disease, dalam: Applied Therapeutic The Clinical Use of Drugs. Wolter Kluwers, Lippincott.

Tsao, G., Sanyal, A.J., Grace, N., dan Carey, W., 2007. Prevention and Management of

Gastroesophageal Varices and Variceal Hemorrhage in Cirrhosis. Journal of Hepatology, 46: 922–938.

Wells, M., Chande, N., Adams, P., Beaton, M., Levstik, M., Boyce, E., dkk., 2012. Meta-analysis: vasoactive medications for the management of acute variceal bleeds. Alimentary pharmacology & therapeutics, 35: 1267–1278.

Widjaja, F. dan Karjadi, 2011. Pencegahan Perdarahan Berulang pada Pasien Sirosis Hati. J Indon Med Assoc, 61: 417–424.

Yang, J.M. Xian, Y.F. Ip, P.SP.P, Wu, J.C.Y, Lao,L.Fong, H.H.S.dkk., 2012. Schisandra Chinensis Reverse Visceral Hipersensitivity in a neonatal-maternal separated Rat Model. Phytomedicine, 19(5): 402-408.



DOI: https://doi.org/10.22146/jmpf.270

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