Evaluasi Kesesuaian Terapi, Luaran Terapi, dan Efek Samping Penggunaan DMARD dan NSAID pada Pasien Artritis Reumatoid di Instalasi Rawat Jalan RSUP Dr. Sardjito Yogyakarta Periode Maret - April 2016

AYUNIASARI SATYAWATI, Prof. Dr. Zullies Ikawati, Apt.

2016 | Skripsi | S1 FARMASI

Artritis reumatoid merupakan penyakit kronis yang memerlukan terapi dalam jangka panjang. DMARD dan NSAID sebagai lini pertama terapi artritis reumatoid dapat menimbulkan masalah ketidaksesuaian penggunaan dan munculnya efek samping jika digunakan dalam jangka panjang. Tujuan penelitian ini untuk mengetahui kesesuaian dan luaran terapi penggunaan DMARD dan NSAID yang dibandingkan dengan tatalaksana terapi artritis reumatoid oleh Perhimpunan Reumatologi Indonesia, serta efek samping dari penggunaan keduanya pada pasien artritis reumatoid di Instalasi Rawat Jalan RSUP Dr. Sardjito Yogyakarta periode Maret-April 2016. Penelitian ini merupakan penelitian deskriptif dengan rancangan cross sectional. Subyek penelitian sebanyak 30 pasien dipilih dengan metode purposive sampling. Data dipeoleh melalui wawancara dan penelusuran rekam medik pasien. Evaluasi kesesuaian terapi dengan menganalisis ketepatan pengobatan dan outcome terapi. Evaluasi efek samping menggunakan Algoritma Naranjo. Hasil penelitian menunjukkan kombinasi metotreksat dan meloksikam merupakan kombinasi DMARD dan NSAID yang paling banyak digunakan pada pasien artritis reumatoid (66,67%). Pasien artritis reumatoid sebagian besar mengalami kesesuaian penggunaan DMARD dan NSAID dengan outcome terapi baik (33,33%), sedangkan ketidaksesuaian penggunaan obat dengan outcome terapi buruk juga banyak terjadi (23,33%). Efek samping yang banyak terjadi pada penggunaan DMARD dan NSAID adalah efek samping pada saluran gastrointestinal, seperti dispepsia, mual, dan muntah dengan kemungkinan tingkat kejadian possible dan probable.

Rheumatoid Arthtritis is a chronic disease which requires a long-term therapy. DMARD and NSAID as first-line therapy for rheumatoid arthtritis can cause several problems such as unsuitability of the use of drugs and the appearance of side effects if it is used in the long term. Aim of this study is to discover the compatibility and outcomes of the therapy by the use of DMARD and NSAID which compared with the management therapy of rheumatoid arthritis by Perhimpunan Reumatologi Indonesia (Indonesian Rheumatology Association), and discover the side effects of the use of DMARD and NSAID in patients with rheumatoid arthritis in Instalasi Rawat Jalan (outpatients instalallation) RSUP Dr. Sardjito Yogyakarta during March - April 2016. This research is a descriptive research with cross sectional design. Subjects of this research were 30 patients who were selected by purposive sampling method. Data was obtained through interviews and quests of medical records of the patients. Evaluation of the suitability of the therapy was perfomed by analyzing the appropriate treatments and therapy outcomes. Evaluation of side effects was done using Naranjo algorithm. The results showed that the combination of methotrexate and meloxicam was a combination of DMARD and NSAID which most widely used in rheumatoid arthritis patients (66.67%). Most of rheumatoid arthritis patients were suitable of the use of DMARD and NSAID with good theraphy outcome (33.33%), whereas patients who had unsuitable therapy with poor therapy outcome also happened (23.33%). Side effects that occur of the use of DMARDs and NSAIDs were the side effects on the gastrointestinal tracts, such as dyspepsia, nausea, and vomiting with the possibility of an occurence level was possible and probable.

Kata Kunci : Kesesuaian, Efek Samping, DMARD, NSAID