Narrative Review: Adverse Drug Reactions pada Terapi Kanker Payudara

IDA NUR AINI, Dr. Ika Puspitasari, M.Si., Apt; Mawardi Ihsan, S.Farm., M.Sc., Apt

2021 | Skripsi | S1 FARMASI

Adverse Drug Reactions (ADRs) merupakan efek yang tidak diinginkan dari kemoterapi kanker payudara. Insiden ADRs akibat kemoterapi dikatakan tinggi karena pasien kanker payudara termasuk populasi yang rentan terhadap kompleksitas rejimen kemoterapi. Frekuensi kejadian ADRs seperti mual dan muntah juga dikatakan tinggi dan menyusahkan kehidupan pasien. Selain itu, ADRs dapat memperlama pemulihan dan mengganggu kualitas hidup pasien apabila ADRs tidak segera ditangani. Identifikasi ADRs sedari awal penting dilakukan untuk mencegah kejadiannya serta memastikan kualitas hidup pasien terjamin. Penelitian ini bertujuan untuk mengulas manifestasi klinis ADRs beserta faktor yang memengaruhinya dan manajemen ADRs pada pasien dengan kanker payudara. Penelitian ini menggunakan metode studi literatur yang disusun menjadi naskah narrative review. Pencarian literatur dilakukan di beberapa database yaitu PubMed, Scopus, ScinceDirect, EBSCOhost, ProQuest dan Cochrane Library. Pencarian artikel dilakukan dengan memasukkan kata kunci meliputi �¢ï¿½ï¿½adverse drug reactions�¢ï¿½ï¿½, �¢ï¿½ï¿½breast cancer�¢ï¿½ï¿½, �¢ï¿½ï¿½risk factor�¢ï¿½ï¿½, �¢ï¿½ï¿½management�¢ï¿½ï¿½, �¢ï¿½ï¿½adverse effects�¢ï¿½ï¿½, �¢ï¿½ï¿½side effects�¢ï¿½ï¿½ dan obat antikanker spesifik. Melalui proses seleksi judul dan abstrak artikel diperoleh 79 artikel yang memenuhi kriteria inklusi. Melalui proses seleksi full-text diperoleh 36 artikel yang akan dianalisis. Hasil analisis 36 artikel menunjukkan bahwa manifestasi klinis ADRs akibat kemoterapi kanker payudara terdiri dari manifestasi klinis hematologi yaitu anemia, neutropenia, leukopenia dan trombositopenia serta manifestasi klinis nonhematologi berupa gangguan gastrointestinal, sistem saraf pusat, dermatologis, kardiovaskular, hepar, neuromuskular dan skeletal, endokrin dan metabolik serta keseimbangan cairan dan elektrolit. Manifestasi klinis ADRs tersebut dipengaruhi oleh beberapa faktor antara lain faktor pasien seperti usia, Body Mass Index (BMI), komorbiditas vaskular, reseptor progesteron, kadar bilirubin dan kadar neutrofil, faktor yang berkaitan dengan terapi seperti intensitas dosis kemoterapi dan jumlah siklus kemoterapi, serta faktor lain seperti aktivitas fisik dan penggunaan antioksidan. Manajemen yang dilakukan guna mencegah dan menangani ADRs antara lain dengan intervensi farmakologis berupa pemberian terapi suportif dan terapi profilaksis serta penggunaan herbal.

Adverse Drug Reactions (ADRs) are an unwanted effect of breast cancer chemotherapy. The incidence of chemotherapy-induced ADRs is said to be high because breast cancer patients are among the population vulnerable to the complexity of chemotherapy regimens. The frequency of occurrence of ADRs such as nausea and vomiting was also said to be high and troublesome for the patient's life. In addition, ADRs can prolong recovery and impair a patient's quality of life if they are not treated promptly. Early identification of ADRs is important to prevent its occurrence and ensure that the patient's quality of life is guaranteed. This study aims to review the clinical manifestations of ADRs and their influencing factors and the management of ADRs in patients with breast cancer. This study uses a literature study method which is structured into a narrative review script. Literature searches were carried out in several databases, namely PubMed, Scopus, ScinceDirect, EBSCOhost, ProQuest and the Cochrane Library. Search for articles was conducted by entering keywords including "adverse drug reactions", "breast cancer", "risk factors", "management", "adverse effects", "side effects" and specific anticancer drugs. Through the process of selecting the title and abstract of the articles, 79 articles that met the inclusion criteria were obtained. Through the full-text selection process, 36 articles were analyzed. The results of the analysis of 36 articles showed that the clinical manifestations of ADRs due to chemotherapy for breast cancer consisted of hematological clinical manifestations, namely anemia, neutropenia, leukopenia and thrombocytopenia as well as non-hematological clinical manifestations in the form of gastrointestinal, central nervous system, dermatological, cardiovascular, liver, neuromuscular and skeletal disorders. endocrine and metabolic as well as fluid and electrolyte balance. The clinical manifestations of ADRs are influenced by several factors, including patient factors such as age, Body Mass Index (BMI), vascular comorbidities, progesterone receptors, bilirubin and neutrophil levels, factors related to therapy such as chemotherapy dose intensity and number of chemotherapy cycles, as well as factors others such as physical activity and the use of antioxidants. Management carried out to prevent and treat ADRs includes pharmacological interventions in the form of supportive therapy and prophylactic therapy and the use of herbs.

Kata Kunci : kanker payudara, kemoterapi, adverse drug reactions