Studi Penggunaan Profilaksis Stress Ulcer pada Pasien Bedah Digestif di RSUD dr.Soetomo Surabaya
DOI:
https://doi.org/10.21776/ub.pji.2020.005.02.1Abstract
Abstrak
Profilaksis stress ulcer seringkali disertai dengan penggunaan yang tidak tepat indikasi dan berlebihan pada pasien non-critically ill atau hospitalized patients. Hal ini dapat berdampak pada peningkatan biaya pengobatan, potensi interaksi obat, efek samping dan length of stay pasien di rumah sakit. Studi ini dilaksanakan dengan metode retrospektif dari data rekam medik kesehatan periode Januari – Desember 2015 di RSUD dr. Soetomo, Surabaya, Jawa Timur dengan tujuan untuk mengetahui pola penggunaan profilaksis stress ulcer, khususnya pada pasien bedah digestif. Sejumlah 40 pasien memenuhi kriteria inklusi. Hasil dari kajian ini menunjukkan bahwa profilaksis diberikan dengan frekuensi 1 – 3 kali/hari baik secara tunggal atau kombinasi dengan rute per oral maupun intravena. Pemberian profilaksis stress ulcer tunggal pada pasien bedah digestif yang terbesar adalah ranitidin (62%). Sedangkan untuk pemberian kombinasi, yang paling banyak diberikan adalah antagonis H2 – PPI (12,5%). Durasi pemberian profilaksis stress ulcer pada hospitalized pasien didasarkan pada kondisi klinis pasien, yaitu mual dan muntah.
Kata kunci: Stress ulcer; profilaksis; bedah digestif; omeprazol; ranitidin
References
Tham TCK, Collins JS., Soetikno R. Gastrointestinal Emergencies Third Edition. Third Edit. Blackwell Publishing; 2016. 276–277 p.
Ganet-Schoeller M, Ducamp M. Gastrointestinal Disorder. In: Dipiro J, Schwinghammer T, editors. Pharmacotherapy Handbook. 9th ed. Mc Graw Hill; 2015. p. 251.
Plummer MP, Blaser AR, Deane A. Stress Ulceration: Prevalence, Pathology and Association with Adverse Outcomes. 2014;18(213):1–7. Available from: papers2://publication/uuid/47271145-D3EF-497D-9FE2-2CCF86975FD6
Singh H, Houy TL, Singh N, Sekhon S. Gastrointestinal prophylaxis in critically ill patients. Crit Care Nurs Q. 2008;31(4):291–301.
Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Drugs Affecting Gastrointestinal Function. In: Brunton L, editor. Goodman & Gillman’s the Pharmacological Basis of Therapeutics. 12th ed. Mc Graw Hill; 2014. p. 1037.
Guillamondegui OD, Gunter OLJ, Bonadies J a, Coates JE, Kurek SJ, De Moya M a, et al. Practice management guidelines for stress ulcer prophylaxis. East Assoc Surg Trauma [Internet]. 2008;1–24. Available from: http://www.east.org/resources/treatment-guidelines/
Spirt M, Stanley S. Update on Stress Ulcer Prophylaxis in Critically Ill Patients. Crit Care Nurse. 2006;26(1):18–28.
Mohamad MS, Shamsuddin N, Tan KM. Appropriateness of stress ulcer prophylaxis among older adults admitted to general medical wards in a university hospital. Eur Geriatr Med [Internet]. 2015;6(2):119–23. Available from: http://dx.doi.org/10.1016/j.eurger.2014.11.004
Malhis A, Alghamdi T, Alfandi R, Issa Z, Alanazi H, Alfintoukh H, et al. Appropriateness of acid-suppressing agents for stress ulcer prophylaxis in non-intensive care unit setting in Saudi Arabia. J Pharm Bioall Sci. 2019;11(1):96–101.
Pitchumoni CS, Dharmarajan TS. Geriatric gastroenterology. In: Pitchumoni CS, editor. Geriatric Gastroenterology. First Edit. Springer; 2012. p. 421–7.
Hong MT, Monye LC, Seifert CF. Acid Suppressive Therapy for Stress Ulcer Prophylaxis in Noncritically Ill Patients. Ann Pharmacother. 2015;49(9):1004–8.
McRorie JW, Kirby JA, Miner PB. Histamine 2 -receptor antagonists: Rapid development of tachyphylaxis with repeat dosing . World J Gastrointest Pharmacol Ther. 2014;5(2):57.
Fohl AL. Proton pump inhibitor-associated pneumonia: Not a breath of fresh air after all? World J Gastrointest Pharmacol Ther. 2011;2(3):17.
Alhazzani W, Alshamsi F, Belley-Cote E, Heels-Ansdell D, Brignardello-Petersen R, Alquraini M, et al. Efficacy and safety of stress ulcer prophylaxis in critically ill patients: a network meta-analysis of randomized trials. Intensive Care Med [Internet]. 2018;44(1):1–11. Available from: https://doi.org/10.1007/s00134-017-5005-8
Shin JM, Kim N. Pharmacokinetics and pharmacodynamics of the proton pump inhibitors. J Neurogastroenterol Motil. 2013;19(1):25–35.
Alsultan M, Mayet A, Malhani A, Alshaikh M. Pattern of intravenous proton pump inhibitors use in ICU and Non-ICU setting: A prospective observational study. Saudi J Gastroenterol. 2010;16(4):275–9.
Barletta JF, Kanji S, MacLaren R, Lat I, Erstad BL, Bartlett B, et al. Pharmacoepidemiology of stress ulcer prophylaxis in the United States and Canada. J Crit Care [Internet]. 2014;29(6):955–60. Available from: http://dx.doi.org/10.1016/j.jcrc.2014.06.025
Yilmaz Ş, Bayan K, Tüzün Y, Dursun M, Canoruç F. A head to head comparison of oral vs intravenous omeprazole for patients with bleeding peptic ulcers with a clean base, flat spots and adherent clots. World J Gastroenterol. 2006;12(48):7837–43.
Katzung BG, Masters SB, Trevor AJ. Special Topics. In: Basic and Clinical Pharmacology. 12th ed. Mc Graw Hill; 2012. p. 1081–114.
Clark K, Lam LT, Gibson S, Currow D. The effect of ranitidine versus proton pump inhibitors on gastric secretions: A meta-analysis of randomised control trials. Anaesthesia. 2009;64(6):652–7.
Zeitoun A. Stress ulcer prophylaxis guidelines: Are they being implemented in Lebanese health care centers? World J Gastrointest Pharmacol Ther. 2011;2(4):27.
Armstrong TA, Coursin DB, Devlin J, Duke JS, Fish D, Edgar R, et al. Stress ulcer prophylaxis ASHP Report ASHP Therapeutic Guidelines on Stress Ulcer. In Am J Health-Syst Pharm; 1999. p. 347–79.
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