Penggunaan Antikoagulan Pada Pasien Covid-19 di RS PKU Muhammadiyah Bantul Periode Maret 2020 - Maret 2021

Iin Ike Ardiani; Woro Supadmi; Endang Yuniarti

doi:10.22146/farmaseutik.v18i4.78638

Penggunaan Antikoagulan Pada Pasien Covid-19 di RS PKU Muhammadiyah Bantul Periode Maret 2020 - Maret 2021

https://doi.org/10.22146/farmaseutik.v18i4.78638

Iin Ike Ardiani⁽¹⁾, Woro Supadmi^(2*), Endang Yuniarti⁽³⁾

(1) Fakultas Farmasi, Universitas Ahmad Dahlan
(2) Fakultas Farmasi, Universitas Ahmad Dahlan
(3) Rumah Sakit PKU Muhammadiyah Yogyakarta
(*) Corresponding Author

Abstract

Covid-19 menyebabkan meningkatnya nilai D-Dimer. Penatalaksanaan terapi Covid19 menggunakan antikoagulan, antikoagulan mempunyai efek samping perdarahan yang harus dipantau seperti epistaksis, hematuria, hematoma, gingivitis, dan melena. Tujuan penelitian untuk mengetahui karakteristik pasien, ketepatan regimen terapi Invicloth dan Lovenox, perbaikan kondisi pasien dan efek samping berdasarkan respon klinis, hubungan antara ketepatan regimen terapi dengan perbaikan kondisi klinis pasien dan kejadian efek samping antikoagulan. Jenis penelitian deskriptif-analitik dengan rancangan cohort, pengambilan data secara retrospektif. Data yang diambil adalah rekam medik pasien dewasa yang terdiagnosis terkonfirmasi Covid-19. Sampel yang diambil adalah semua pasien terkonfirmasi Covid-19 yang menggunakan antikoagulan Invicloth dan Lovenox selama periode Maret 2020-Maret 2021 dengan kriteria inklusi dan eksklusi. Data yang diambil meliputi usia, jenis kelamin, diagnosis Covid-19 atau bersama komorbid lain, data klinis, data obyektif dan subyektif, lama rawat inap serta data profil penggunaan antikoagulan. Perbaikan klinis yang diamati berupa DDimer, trombosit, Hb, dan APTT/PTT. Data dianalisis univariat dan bivariat untuk mengetahui hubungan antara ketepatan regimen terapi dengan perbaikan klinis dengan chi-square. Hasil penelitian menunjukkan 75 pasien memenuhi kriteria inklusi. Pasien laki-laki lebih banyak 61.3%. Usia ≤ 60 tahun adalah usia yang paling tinggi 73.4%. Invicloth digunakan paling sering 90.7%, Lovenox 9.3%. Lama penggunaan Invicloth dan Lovenox < 7 hari 62.6%. Distribusi pasien kebanyakan dengan komorbid 66.6%, terbesar Diabetes Melitus 20%. Efek samping Invicloth muncul trombositopenia 3 orang(4%), anemia 9 orang (12%) dan adanya perdarahan (BAB diare berdarah 2,6% dan muntah darah 1,3%), sedangkan Lovenox 16% (nilai APTT tinggi namun tidak tampak tanda perdarahan pada pasien). Pasien membaik 80%. Ketepatan regimen Invicloth 72% dan Lovenox 2,6%. Rata-rata D-Dimer saat pemeriksaan awal 1.156 ng/mL (nilai normal D-dimer < 0.5 ng/mL) sedangkan pemeriksaan akhir rata-rata 0.58 ng/mL. Hubungan ketepatan regimen antikoagulan dengan perbaikan klinis dan efek sampingnya diuji secara chi-square didapat D-dimer p=0.626, trombosit p=1.00, Hb p=0,49, APTT/PTT p=1,00, dan efek samping antikoagulan p=0.259, dimana p> 0.05. Tidak ada hubungan antara ketepatan regimen antikoagulan dengan perbaikan klinis pasien dan efek samping antikoagulan.

Keywords

Covid-19; ketepatan regimen; Invicloth; Lovenox; respon klinis

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DOI: https://doi.org/10.22146/farmaseutik.v18i4.78638