Identifikasi Potensial Interaksi Obat Cisplatin pada Pasien Kanker Paru Rawat Inap di RSUP Dr. Sardjito Yogyakarta

NAILA 'AZZA FAUZIYAH, Dr. apt. Fita Rahmawati, Sp. FRS.

2024 | Skripsi | FARMASI

Interaksi obat merupakan masalah yang menjadi perhatian serius dalam setiap pengobatan, salah satunya pengobatan kanker. Banyaknya jumlah obat yang digunakan secara bersamaan dapat meningkatkan risiko interaksi obat. Selain itu, obat antikanker biasanya memiliki indeks terapeutik yang sempit dan bisa menyebabkan dampak yang signifikan akibat perubahan kecil pada aktivitas obat. Penelitian ini bertujuan mengidentifikasi potensial interaksi obat pada pasien kanker paru yang menggunakan kemoterapi cisplatin dan efek samping yang timbul akibat interaksi obat cisplatin.

Penelitian ini menggunakan metode cross-sectional dengan pengambilan data secara retrospektif. Subjek pada penelitian ini yaitu pasien kanker paru rawat inap yang menggunakan kemoterapi cisplatin di RSUP Dr. Sardjito Yogyakarta selama Bulan Juli 2022 – Desember 2023. Pengambilan sampel menggunakan metode purposive sampling dan diperoleh 100 data rekam medis pasien sesuai kriteria inklusi. Data yang diambil berupa data karakteristik pasien, data pengobatan, dan data penunjang seperti hasil laboratorium. Dilakukan analisis interaksi obat menggunakan situs database online interaction checker www.drugs.com dan buku Drug Interaction Facts. Dilakukan penilaian kausalitas efek samping terkait interaksi obat menggunakan Algoritma Naranjo. Data yang diperoleh diinterpretasikan secara deskriptif untuk menggambarkan interaksi obat dan efek samping terkait interaksi obat.

Hasil penelitian menunjukkan terdapat 470 potensial interaksi obat pada 100 pasien (100%) yang terdiri atas 450 interaksi moderate dan 20 interaksi minor. Sebanyak 197 kejadian (41,9%) potensial interaksi obat tidak diketahui mekanisme interaksinya (unknown) dan 182 kejadian (38,7%) merupakan interaksi farmakodinamik. Terdapat 30 pasien yang diduga mengalami efek samping terkait interaksi obat dengan efek samping paling banyak yaitu mielosupresi akibat interaksi obat cisplatin-paclitaxel. Hasil analisis Algoritma Naranjo terhadap kejadian efek samping terkait interaksi obat menunjukkan skala probabilitas possible/cukup mungkin. 

Drug interactions are a problem that is a serious concern in every treatment, one of which is cancer treatment. A large number of drugs used simultaneously can increase the risk of drug interactions. Futhermore, anticancer drugs usually have a narrow therapeutic index and can cause significant effects due to small changes in drug activity. This study aims to identify potential drug interactions in lung cancer patients using cisplatin chemotherapy and the side effects that arise due to cisplatin drug interactions. 

This study used a cross-sectional method with retrospective data collection. The subjects in this study were inpatient lung cancer patients who were using cisplatin chemotherapy at RSUP Dr. Sardjito Yogyakarta during July 2022 – December 2023. Sampling used a purposive sampling method and obtained 100 patient medical record data according to the inclusion criteria. The data taken is in the form of patient characteristic data, treatment data, and supporting data such as laboratory results. Drug interaction analysis was carried out using the online interaction checker database site www.drugs.com and the Drug Interaction Facts book. An assessment of the causality of side effects related to drug interactions was carried out using the Naranjo Algorithm. The data obtained was interpreted descriptively to describe drug interactions and side effects related to drug interactions.

The research results showed that there were 470 potential drug interactions in 100 patients (100%) consisting of 450 moderate interactions and 20 minor interactions. A total of 197 events (41.9%) had potential drug interactions with unknown mechanisms and 182 events (38.7%) were pharmacodynamic interactions. There were 30 patients who were suspected of experiencing side effects related to drug interactions with the most common side effect being myelosuppression due to the cisplatin-paclitaxel drug interaction. The results of the Naranjo Algorithm analysis of side effects related to drug interactions show a “possible”/quite likely probability scale.

Kata Kunci : Interaksi Obat, Cisplatin, Kanker Paru, Kemoterapi