Studi Efek Samping Obat Antiplatelet Pada Pasien Stroke Iskemik di Bangsal Rawat Inap Rumah Sakit Akademik UGM Yogyakarta

FIRSTY FRIDANI, apt. Rr. Fivy Kurniawati, M.Sc.

2021 | Skripsi | S1 FARMASI

Stroke adalah salah satu penyebab utama disabilitas di seluruh dunia. Sebanyak 80% stroke di Indonesia adalah stroke iskemik. Antiplatelet diberikan 24-48 jam setelah serangan stroke dan dapat mencegah stroke berulang. Penelitian ini bertujuan untuk mengetahui pola penggunaan antiplatelet, efek samping antiplatelet dan manajemennya, luaran klinis, hubungan karakteristik pasien dengan efek samping, serta pengaruh efek samping terhadap luaran klinis pasien stroke iskemik di bangsal rawat inap RSA UGM. Penelitian ini adalah penelitian cross-sectional dengan pengambilan data secara retrospektif dari rekam medis. Populasi penelitian yaitu pasien dewasa berusia lebih dari 18 tahun, didiagnosis utama stroke iskemik, dan mendapatkan antiplatelet di rawat inap di RSA UGM Yogyakarta periode Juni 2019-Juni 2020. Subyek dipilih secara purposive sampling yang memenuhi kriteria inklusi. Efek samping dievaluasi menggunakan pedoman Meyler's Side Effects of Cardiovascular Drugs Elsevier, Drug Information Handbook 17th Edition, dan WHO-UMC untuk kategori efek samping. Data pola penggunaan antiplatelet, efek samping antiplatelet dan manajemenya, serta luaran klinis dianalisis secara deskriptif. Uji chi-square dilakukan untuk melihat signifikansi hubungan efek samping dengan karakteristik pasien dan luaran klinis. Hasil penelitian dari 113 pasien, 40.71% pasien mendapatkan kombinasi aspirin-klopidogrel. Efek samping aktual yaitu mual dan muntah 1 pasien, nyeri perut 2 pasien, stress ulcer 1 pasien, dan nyeri ulu hati 1 pasien. Efek samping potensial yang mungkin terjadi yaitu perdarahan. Pemberian PPI seperti pantoprazol direkomendasikan untuk mengatasi efek samping dan gejalanya. Hasil uji Chi-square menunjukkan tidak terdapat hubungan yang bermakna antara efek samping dengan karakteristik pasien (p-value lebih dari 0.05) serta tidak terdapat hubungan yang bermakna antara efek samping terhadap luaran klinis pasien (p-value lebih dari 0.05).

Stroke is one of the leading causes of disability worldwide. A number of 80% of strokes in Indonesia are ischemic strokes. Antiplatelets are given 24-48 hours after a stroke and prevent recurrent strokes. This study aims to determine the pattern of antiplatelet use, antiplatelet side effects and their management, clinical outcomes, the relation between patient characteristics and side effects, and the effect of side effects on clinical outcomes in ischemic stroke patients in RSA UGM. This study was a cross-sectional study with retrospective data collection from medical records. The study population was adult patients aged more than equal to 18 years old, major diagnosed with ischemic stroke, and receiving anti-platelets who were hospitalized at RSA UGM Yogyakarta for the period June 2019-June 2020. Subjects were selected by purposive sampling according to inclusion criteria. Adverse effects were evaluated using Meyler's Side Effects of Cardiovascular Drugs Elsevier, Drug Information Handbook 17th Edition, and WHO-UMC for side effect categories. Data will be analyzed descriptively for antiplatelet use patterns, side effects and their management, and clinical outcomes. Chi-square test was conducted to see the significance of the relation between side effects with patient characteristics and clinical outcomes. The results of this study showed that out of 113 patients, 40.71% of patients received the aspirin-clopidogrel combination. The actual side effects that occurred were nausea and vomiting in 1 patients, stomach pain in 2 patients, stress ulcer in 1 patient, and heartburn in 1 patients. A potential side effect that may occur is bleeding. PPIs such as pantoprazole are recommended to overcome the side effects and their symptoms. Chi-square test results showed that there was no significant relationship between side effects and patient characteristics (p-value more than 0.05) and also there was no significant relationship between side effects and patient clinical outcomes (p-value more than 0.05).

Kata Kunci : stroke iskemik, antiplatelet, efek samping, RSA UGM