THE ASSOCIATION BETWEEN THE USE OF NONSTEROIDAL ANTI-INFLAMMATORY DRUGS AND THE OCCURENCE OF GASTROINTESTINAL DISORDERS AT SEVERAL HOSPITALS IN SOUTHEAST SULAWESI

ASRIANTI, Prof. Zullies Ikawati, Apt; DR. Fita Rahmawati, Sp.FRS., Apt

2017 | Tesis | S2 Magister Farmasi Klinik

Obat antiinflamasi nonsteroid (NSAID) adalah obat yang paling efektif untuk agen anti-inflamasi dan analgesik dan termasuk di antara kelas obat yang paling umum digunakan di seluruh dunia. Namun, penggunaannya sering dikaitkan dengan komplikasi gastrointestinal (GI) yang berpotensi serius seperti Penyakit Ulkus Peptik, Dispepsia dan Gastritis. Penelitian ini merupakan studi kasus kontrol yang melibatkan pasien dengan diagnosis penyakit tukak peptik, dispepsia dan gastritis di beberapa rumah sakit di Sulawesi Tenggara, yang memenuhi kriteria inklusi. Pengumpulan data dilakukan dengan metode sampling secara simultan. Subjek diwawancarai untuk riwayat pengobatan, khususnya penggunaan NSAID, termasuk jenis NSAID, dosis, dan durasi. Algoritma Naranjo dan Asesmen Kausalitas WHO-UMC digunakan untuk menilai kausalitas ADR ini. Data yang diperoleh kemudian dianalisis secara statistik dengan menggunakan analisis bivariat dan multivariat. Total subjek adalah 352 pasien dan 195 pasien menggunakan NSAID. Pasien dengan gangguan gastrointestinal 176 subjek dan ada 132 pengguna NSAID dalam kelompok tersebut. Data menunjukkan bahwa NSAID yang paling banyak digunakan adalah Asam Mefenamat oleh 102 pasien (52%) dan Diklofenak oleh 35 pasien (18%). Nilai Chi-Square p <0,001 mengindikasikan asosiasi NSAID yang bermakna secara statistik dengan gangguan GI dengan nilai OR 7,63. Probabilitas kejadian gangguan GI pada pasien adalah 13,4% untuk pria dan 18,6% untuk wanita jika mereka menggunakan NSAID. Wawancara menunjukkan 6 dari 195 pasien mengindikasikan ADR dalam kategori "certain" dan "definite". Faktor yang berhubungan adalah komorbiditas, jenis NSAID, durasi dan dosis. NSAID memiliki hubungan dengan kejadian gangguan gastrointestinal, yakni sekitar 3,08% kelainan gastrointestinal kemungkinan disebabkan oleh NSAID.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most as effective drug for anti-inflammatory and analgesic agents and are among the most commonly used classes of medications worldwide. However, their use has been associated with potentially serious dose-dependent gastrointestinal (GI) complications such as Peptic Ulcer Disease, Dyspepsia and Gastritis. This research was a case-control study involving patients with diagnoses of peptic ulcer disease, dyspepsia and gastritis in several hospitals in Southeast Sulawesi, who fulfills inclusion criteria. The data collection was carried out by concecutive sampling methods. Subjects were interviewed for medication history, specifically the use of NSAIDs, including the type of NSAIDs, dosage, and duration. Naranjo algorithm and WHO-UMC Causality Assessment was used to assess the causality of this ADRs. The data obtained then analyzed statistically using bivariate and multivariate analysis. Total subjects were 352 patients and 195 patients used NSAIDs. Patients with gastrointestinal disorders were 176 subject and there were 132 NSAIDs users in the group. The data showed that the most used NSAIDs were Mefenamic Acid by 102 patients (52%) and Diclofenac by 35 patients (18%). Chi-Square p values <0.001 indicated a statistically significant association NSAIDs with GI disorders. There was OR value of 7.63. The probability measure of the patient GI disorders event was 13.4% for male and 18.6% for female if they used NSAIDs. Interview showed 6 from 195 patients indicated certain and definite ADR. The factors have been associated were comorbidity, NSAIDs type, duration and dosage. NSAIDs are associated with Gastrointestinal disorder event, about 3.08% of Gastrointestinal disorders is likely due to NSAIDs.

Kata Kunci : NSAIDs, Gastrointestinal Disorders, Causality, Risk Factor