Penyesuaian Dosis Obat Berdasarkan Nilai Kreatinin Klirens pada Pasien Geriatri Rawat Inap di Rsup Dr. Kariadi Semarang, Indonesia

https://doi.org/10.22146/farmaseutik.v15i2.46447

Noor Haryati(1*), Fita Rahmawati(2), Djoko Wahyono(3)

(1) Magister Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(2) Magister Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(3) Magister Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Pasien geriatri biasanya mengalami multipathology dan polypharmacy yang dapat mengakibatkan munculnya respon yang berlebihan seperti efek samping bahkan efek toksik. Untuk menghindari hal ini diperlukan penyesuaian dosis berbasis farmakokinetika individual. Penelitian ini bertujuan untuk melihat persentase obat yang membutuhkan adjustment dose pada pasien geriatri berdasarkan kreatinin klirens ginjal yang diukur dengan formula Cockroft-Gault dan menganalisa hubungan ketepatan pendosisan dengan outcome clinic. Penelitian dilakukan dengan rancangan cross-sectional dengan pengambilan data secara retrospektif melalui penelusuran data rekam medis pasien geriatri rawat inap yang dirawat di RSUP dr. Kariadi Semarang tahun 2017. Data yang diamati adalah regimen pengobatan, serum kreatinin, outcome clinic dan adverse drug reaction yang terjadi. Selanjutnya dilakukan estimasi kreatinin kliren yang dilanjutkan dengan menilai kesesuaian dosis dengan referensi dan formula Giusti Hayton. Analisis data dilakukan secara deskriptif dan uji Chi-square dengan SPSS untuk menganalisa pengaruh penyesuaian dosis dengan clinical outcome. Hasil penelitian menunjukkan dari 100 rekam medis pasien yang memenuhi inklusi terdapat 99 pasien yang mendapatkan obat dan memerlukan penyesuaian dosis. Pasien yang mendapatkan regimen pengobatan tepat sebesar 73%.  Dari 785 obat yang diresepkan, 353 (44,97%) obat memerlukan penyesuaian dosis. Dari obat-obat yang memerlukan penyesuaian dosis tersebut 322 (91,22 %) sudah tepat dan 31 (8,78 %) belum tepat. Obat-obat yang belum tepat dosis adalah ketorolak injeksi, ranitidin injeksi dan beberapa jenis antibiotik (meropenem injeksi, levofloksasin tablet, dan sefiksim tablet). Tidak ada hubungan yang bermakna antara ketepatan dosis dengan outcome clinic (p=0,289)

Keywords


geriatri; kreatinin klirens; penyesuaian dosis; outcome clinic

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DOI: https://doi.org/10.22146/farmaseutik.v15i2.46447

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