oleh :
Butet Desniar Gultom
14000019
Fakultas Kedokteran
Universitas HKBP Nommensen
2017
Bab 1. Pendahuluan
Latar Belakang
3
United State
Western Pain Society, 2012
- Resep : 98 juta
- Tidak memakai resep : 23 juta
4
Indonesia
Miftah, 2014
Tunggal : Natrium diklofenak 51,6%
Kombinasi : Natrium Diklofenak &
metilprednisolon 64,8 %
Apotek Gs
Kudus
Lampung
Dian & Wardani, 2017
AINS : 62,2 % dengan
meloxicam 45,5%.
Cara pemberian 100% oral
RS. Abdoel Moeloek
5
Sakit Kepala
Flu
AINS
Demam
Jangka
panjang
Peradangan Efek Samping &
Sendi toksisitas
Berdasarkan uraian diatas peneliti tertarik
untuk melakukan penelitian mengenai
gambaran pola peresepan anti-inflamasi
non-steroid di Instalasi Farmasi RSUD Dr.
Pirngadi Kota Medan November 2016
7
Rumusan Masalah
Bagaimana pola
peresepan AINS yang
digunakan berhubungan dengan
kemungkinan terjadinya efek samping
pada pasien di RSUD Dr. Pirngadi ?
8
Tujuan Penelitian
1. Untuk Mengetahui jenis dan sediaan AINS yang sering Tujuan Khusus
digunakan.
2. Untuk mengetahui dosis yang digunakan berdasarkan lama
pemberian, jumlah obat, serta cara pemberian obat AINS.
3. Untuk mengetahui obat yang sering dikombinasikan dengan
AINS.
Manfaat Penelitian
10
Bab 2. Tinjauan Pustaka
11
Resep
Definisi
13
Rasionalitas
Kepatuhan
Pasien
Tepat Tindak Lanjut
15
Mekanisme
Membran sel
Phospholipase
A2
Asam Arakidonat
NSAID
s
Lipoxygenase Cyclooxygenase
Klasifikasi
Asam
Ains Salisilat Derivat Asam Derivat Asam
Asetat Propionad
Inhibitor Derivat
Derivat Derivat Asam
Para-Aminofe
Non-Selektif nol Fenamat Enolat
Selekoksib
Etorikoksib
Ains Selektif Valdekoksib
Lumirakoksib
Parekoksib
Ains Apazon
Lainnya Nimesulid
Penggunaan AINS
Nyeri
Demam
Gangguan Muskuloskeletal
Mastositosis Sistemik
1
8
Lanjutan
Kemoprevensi Kanker
Tolerabilitas Niasin
1
9
19
Kombinasi Obat
Antagonisme
Sinergisme
Interaksi Obat
-blockers Efek
Kombinasi
AINS ACE-Inhibi Obat
tor Menurun
Aspirin
Indometasin Efek
Asam Anti Kombinasi
Mefenamat koagulan Obat
Fenilbutazon Meningkat
Sulindak
Lanjutan
Antasida
Probenesid Efek AINS
Aspirin Sulfinpirazon Menurun
Vitamin C
Oksifenbutaz
on Obat-obat Efek AINS
Diabetes Meningkat
Fenilbutazon
Efek samping
Ulkus & Perdarahan Dispepsia
Anoreksia Nyeri Abdomen
Mual Diare
24
Bab. 3
METODOLOGI PENELITIAN
Desain Penelitian
Deskriptif-Retrospektif
Tempat dan Waktu Penelitian
September-November 2017
27
POPULASI PENELITIAN
Populasi Target Populasi Terjangkau
28
SAMPEL Cara
Sampel pada penelitian
Pemilihan
ini adalah resep obat
AINS yang dituliskan Total Sampling
oleh dokter yang
masuk di Instalasi
Farmasi RSUD
Dr.Pirngadi Kota
Medan pada bulan
November 2016.
29
DEFINISI OPERASIONAL
30
ALUR PENELITIAN
31
ANALISIS DATA
Analisis
Univariat
32
Daftar Pustaka
1. Furst DE, Ulrich RW. Obat Anti-Inflamasi Nonsteroid; Obat Antireumatik Pemodifikasi Penyakit, Analgesik Nonopioid
& Obat yang Digunakan pada Gout. Dalam: Bertram G Katzung, editor. Farmakologi Dasar & Klinik. 10th ed. Jakarta: EGC;
2007. hal 589600.
2. Wallace JL. Mechanisms , Prevention and Clinical Implications of Nonsteroidal Anti-Inflammatory Drug-Enteropathy.
2013;19(12):2.
3. A Public Health Coalition. Important Facts about Nonsteroidal Anti-inflammatory Drugs ( NSAIDs ). WPS. 2012;
4. Hasanah M. Drug Prescribing Pattern in the Early Management of Rheumatoid Arthritis Patient in Abdoel Moeloek
Hospital in Bandar Lampung Period July 2012-June 2013. 2014;1.
5. Palupi DA, Wardani PI. Tingkat Penggunaan Obat Anti Inflamasi Non Steroid (AINS) di Apotek Gs Kabupaten Kudus.
Cendekia Utama. 2017;2(5).
6. FDA U.S. Food and Drug Administration. Medication Guide for Non-Steroidal Anti-Inflammatory Drugs.
7. Cardile S, Martinelli M, Barabino A, Gandullia P, Oliva S, Nardo G Di, et al. Italian Survey on Non-Steroidal
Anti-Inflammatory Drugs and Gastrointestinal Bleeding in Children. 2016;22(5):2.
8. Varga Z, Vargova V. Cardiovascular Risk of Nonsteroidal Anti- Inflammatory Drugs: An Under-Recognized Public
Health Issue The cyclooxygenase enzyme and its physiologic roles. 2017;9(4):4.
9. Menteri Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Republik Indonesia. Jakarta; 2016.
10. Syamsuni H. Ilmu Resep. Elviana E, Syarief WR, editors. Jakarta: EGC; 2006. hal 18-27.
11. Suharmi S. Pengantar Ilmu Farmasi Kedokteran & Resep Dokter. Dalam: Ilmu Farmasi Kedokteran. Yogyakarta; hal
67.
12. Kementerian Kesehatan Republik Indonesia. Modul Penggunaan Obat Rasional. Jakarta; 2011
13. Lofholm PW, Katzung BG. Menulis Resep dengan Benar & Rasional. Dalam: Katzung BG, Masters SB, Trevor AJ,
editors. Farmakologi Dasar & Klinik. 12th ed. Jakarta: EGC; 2012. hal 12934.
14. Stringer JL. Konsep Dasar Farmakologi. Manurung J, editor. Jakarta: EGC; 2006. hal 288-297.
15. Baratawidjaja KG, Iris Rengganis. Imunologi Dasar. 10th ed. Jakarta: Badan Penerbit Fakultas Kedokteran UI;
16. Brunton L, Parker K, Blumentahl D, Buxton I. Manual Farmakologi dan Terapi. 2008. hal 398-429.
17. Wilmana PF, Gan S. Analgesik-Antipiretik, Analgesik Anti-Inflamasi Nonsteroid, dan Obat Gangguan Sendi lainnya.
Dalam: Gunawan SG, editor. Farmakologi dan Terapi. 5th ed. Jakarta: FK-UI; 2012. hal 23046.
18. FDA U.S. Food and Drug Administration. COX-2 Selective (Include Bextra, Celebrex, and Vioxx) and Non-Selective
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). 2015.
19. Ping NH, dkk, editors. MIMS Petunjuk Konsultasi. 15th ed. Singapore: Ben Yeo; 2015. hal 121-138.
20. Hulaima IS, Carolia N. OAINS sebagai Kemoprofilaksis Kanker Kolorektal. 2016;5:15.
21. Dishy V, Liu F, Ebel DL, Atiee GJ, Royalty J, Reilley S, et al. Effects of Aspirin When Added to the Prostaglandin D 2
Receptor Antagonist Laropiprant on Niacin-Induced Flushing Symptoms. J Clin Pharmacol [Internet]. 2009 Apr 1 [cited 2017
Aug 3];49(4):41622. Available from: http://doi.wiley.com/10.1177/0091270009332246
22. Tjay TH, Rahardja K. Obat-Obat Penting. 6th ed. Jakarta: PT Gramedia; 2008. hal 49-53.
23. Harkness R. Interaksi Obat. Agoes G, Widianto MB, editors. Bandung: ITB; 2013. hal 17-30.
24. Important Facts about Nonsteroidal Anti-inflammatory Drugs (NSAIDs). [cited 2017 Jun 6]; Available from:
http://www.nsaidalliance.com/wp-content/uploads/2014/10/NSAID-Alliance-NSAID-Fact-Sheet.pdf
25. Disease D, Committed S, Care P. American College of Gastroenterology Common Gastrointestinal Problems
Common GI Problems in Women: The Dangers of Aspirin & NSAIDs Aspirin & NSAIDs.
26. Tongeren BJMZ Van, Rook LA, Mantel-teeuwisse AK. Priority Medicines for Europe and the World A Public Health
Approach to Innovation Update on 2004 Background Paper Background Paper 7 . 2 Priority Medicines for Women.
Netherlands; 2013.
27. McGettigan P, Henry D. Cardiovascular Risk with Non-Steroidal Anti-Inflammatory Drugs: Systematic Review of
Population-Based Controlled Observational Studies. PLoS Med. 2011;8(9).
28. Government TA. NSAIDs and cardiovascular risks: questions and answers [Internet]. 2014. Available from:
https://www.tga.gov.au/node/187455
34
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