* Corresponding Author
EVALUASI DOSIS WARFARIN DAN HASIL TERAPINYA PADA PASIEN RAWAT JALAN
https://doi.org/10.22146/jmpf.284 Nova Hasani Furdiyanti(1*), I Dewa Putu Pramantara(2), Djoko Wahyono(3)
(1)
(2)
(3)
(*) Corresponding Author
Abstract
Penggunaan warfarin dimonitor berdasarkan efek farmakodinamik dari prothrombin time (PT) melalui nilai international normalized ratio (INR). Penelitian ini bertujuan untuk mengetahui perkiraan kadar warfarin dalam darah pasien, hasil terapi pasien yang mendapat terapi warfarin dilihat dari nilai INR, dan mengetahui korelasi antara perkiraan kadar warfarin dengan hasil terapi. Penelitian ini adalah penelitian observasional retrospektif yang bersifat deskriptif dan korelatif. Subjek penelitian adalah pasien rawat
jalan yang mendapat terapi warfarin oral di RSUP dr. Sardjito pada Jnuari 2011 sampai Oktober 2013. Perkiraan kadar warfarin dihitung berdasarkan rumus farmakokinetika, sedangkan analisis korelasi dilakukan dengan analisis korelatif Spearman. Hasil penelitian pada 86 subjek penelitian menunjukkan perkiraan kadar warfarin rata-rata pada keadaan tunak atau pada bulan ke-1 rata-rata sebesar 0,658 ± 0,315 mg/L, nilai rata-rata sebesar 0,135 ± 0,065 mg/L, dan nilai rata-rata sebesar 0,802 ± 0,384 mg/L. Hasil pemeriksaan INR menunjukkan 54 pasien (62,79%) yang rata-rata diberi warfarin dosis 2,15 ± 0,74 mg per hari, tidak mencapai target INR. Nilai INR yang dicapai rata-rata sebesar 1,29 ± 0,30, dengan jangkauan INR 0,90 – 1,93. Sisanya sebanyak 32 pasien (37,21%) yang rata-rata diberi warfarin dosis 2,41 ± 0,80 mg per hari, mencapai target INR rata-rata sebesar 3,10 ± 0,93, dengan jangkauan nilai INR 2,01 - 5,30. Korelasi antara perkiraan kadar warfarin dalam darah dengan nilai INR tidak bermakna dengan nilai p = 0,180 (p > 0,05), sedangkan nilai koefisien korelasi sebesar 0,146 menunjukkan arah korelasi positif dengan kekuatan korelasi yang sangat lemah.
Kata kunci: warfarin, kadar dalam darah, dosis, INR
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DOI: https://doi.org/10.22146/jmpf.284
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