Hubungan Kerasionalan Peresepan Obat Antihipertensi Dengan Outcome Klinis Pada Pasien Stroke Iskemik Rawat Inap RSUD Dr. Soegiri Lamongan

Muhammad Muhlis(1*), Luthfiyya Iffa Muslimah(2)

(1) Ahmad Dahlan University
(2) Departemen Farmasi Klinik dan Sosial, Fakultas Farmasi Universitas Ahmad Dahlan
(*) Corresponding Author

Abstract

Ischemic stroke is a disruption of blood supply to the brain caused by the blockage of blood vessels. Hypertension is a comorbid disease in ischemic stroke. Appropriate treatment can affect the success of therapy and the achievement of the desired blood pressure. This study aims to evaluate the rationale for using antihypertensive drugs to achieve clinical outcomes in the form of blood pressure. This study was designed in an observational analytic manner with a cross-sectional approach, retrospective in nature with a purposive sampling method in ischemic stroke patients who received antihypertensive prescriptions in RSUD Dr. Soegiri Lamongan. The sample used was 100 patients. The results showed that the most widely used antihypertensive drugs were CCB with a percentage of 41.8%, ARB with a percentage of 27.6%. The rationale for prescribing was obtained: 100% correct indication, 100% correct patient, 91% correct drug, and 100% correct dose. The results of the Chi-Square test have obtained an expected value of < 5, so that it is followed by the Fisher's Test, which obtained a p-value of 0.021 (p <0.05). The conclusion of this study is that patients who received a rational antihypertensive prescription were 91%, for patients who achieved clinical outcomes as much as 86% and there was a relationship between the rationality of prescribing antihypertensive drugs with clinical outcomes in the form of achieving target blood pressure in ischemic stroke patients at RSUD Dr. Soegiri Lamongan.

Keywords

Stroke iskemik, Kerasionalan resep antihipertensi, Outcome Klinis

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References

Allihat. 2002. Major outcomes in high-risk hypertensive patients randomized to angiotensin-coverting enzym inhibitor, American Medical Association, 288(23):2891-2997

Appleton, J.P., Sprigg, N., Bath, P.M. 2016. Blood pressure management in acute stroke, Stroke and Vasculer Neurology, 1(2): 72-82

Aronow, W.S., Fleg, J.L., Pepine, C.J., Artinian, N.T., Bakris, G., Brown, A.S., Ferdinand, C., Forciea, M.A., Frishman, WH., Jaigobin, C., Kostis, J.B., Mancia, G., Oparil, S., Ortiz, E., Weber, M.A. ACCF/AHA. 2011. expert consensus document on hypertension in the elderly. Journal of American Society of Hypertension 2011;5(4): p. 259-352.

Coylewright, M., Reckelhoff, J. F., & Ouyang, P. 2008. Menopause and hypertension: an age-old debate. Hypertension, 51(4), 952-959.

Dinicolantonio, J. J., Fares, H., Niazi, A. K., Chatterjee, S., Ascenzo, F. D., Cerrato, E., Keefe, J. H. O. 2015. 𝛽 –Blockers in hypertension, diabetes, heart failure and acute myocardial infarction : a review of the literature, Open Heart,2: 1-12.

ESC/ESH. 2013. Guideline for the management of arterial hypertension, European Heart Journal, [Online], Sumber: https:/academic.oup.com/eurheartj [Akses: 28 Juni 2019]

Goldstein, L.B., Adams, Robert., Alberts, M.J., Appel, L.J., Brass, L.M., Bushnell, C.D., Culebras, A., DeGraba, T.J., Gorelick, P.B., Guyton, J.R.,hart, R.G., Howard, G., Kelly-Hayes, M., Nixonm, J.V., Sacco, R.L. 2011. Primary Prevention of Ischemic Stroke, Stroke, Vol. 42, p.517-584.

Gormer, B. 2010. Farmakologi hipertensi, diterjemahkan oleh Lyrawati, Diana., 1-7, Jakarta

Hankey, G.J. 2003. Angiotensin-converting enzyme inhibitors for stroke prevention is there hope for progress after life, Stroke: 1;34(2):354–6.

JNC 8. 2014. evidance-based guideline for the management of high blood pressure in adult, report from the panel members appointed to the eight Join National Committee (JNC 8) Clinical Review & Education Special Communication, U.S., Departement of Health and Human Services National Institutes of Health National Heart, Lung, and Blood Institute.

Juan, T., Julian, S., & Luis, M. 2014. Diuretics in the treatment of hypertension. part 2: loop diuretic and potassium-sparing agent, Sci., 15(5):605-621.

Junaidi, I. 2011. Stroke waspadai ancamannya. Penerbit Andi, Yogyakarta

Kalra, S., Kalra, B., Agrawal, N. 2010. Combination therapy in hypertension: an update. Diabetology and Metabolic Syndrome Journal. India: BioMed Central Ltd. p. 44

Kemenkes RI 2006. Pharmaceutical care untuk penyakit hipertensi, Direktorat Bina Farmasi Komunitas dan Klinik Ditjen Bina Kefarmasian dan Alat Kesehatan, Jakarta.

Kemenkes RI. 2011. Modul penggunaan obat rasional. Kementrian Kesehatan Republik Indonesia, Jakarta

Karuniawati, H., Ikawati, Z., & Gofir, A. 2015. Pencegahan sekunder untuk menurunkan kejadian stroke berulang pada stroke iskemik. Jurnal Manajemen dan Pelayanan Farmasi, 14, 14-21.

Lacy, C., Armstrong, L. L., Lipsy, R. J., & Lance, L. L. 1993. Drug information handbook 1993. Lexi-comp.

Madscape. 2019. Drug interaction checker, https://reference.medscape.com/drug-interactionchecker

Muir, W., and Keith. 2013. Stroke. Medicine, Vol.41 No.3, p. 169-173

Naidu, M.U., Usha, P.R., Rao, T.R., and Shoba, J.C., 2000. Evaluation of amlodipine, lisinopril, and a combination in the treatment of essential hypertension, India: Department of Clinical Pharmacology and Therapeutics, Nizam’s Institute of Medical Sciences, Volume 76, p. 350-353.

Nazir, F.S., Overell, J.R, Bolster, A., Hilditch, T.E., Lees, K.R. 2019. Effect of perindopril on cerebral and renal perfusion on normotensives in mild early ischaemic stroke: a randomized controlled trial. Cerebrovascular Diseases. 2019;19(2):77–83.

PERDOSSI. 2011. Guideline stroke, Perhimpunan Dokter Spesialis Saraf Indonesia, Jakarta.

Prabhakaran, S. dan Chong, J.Y., 2014, Risk factor management for stroke prevention, Continuum (Minneapolis, Minn. ), 20(2): 296-308.

Ramadhini, A. Z., Angliadi, L. S., & Angliadi, E. 2013. Gambaran angka kejadian stroke akibat hipertensi di instalasi rehabilitasi medik RSUP Prof. Dr. RD Kandou Manado periode Januari–Desember 2011. e-Clinic, 1(2).

Rashid, P., Leonardi-Bee, J., Bath, P. 2003. Blood pressure reduction and secondary prevention of stroke and other vascular events a systematic review. Stroke. 1;34(11):2741–8.

Ravenni, R. 2011. Primary stroke prevention and hypertension treatment: which is the first-line strategy, Neurol Int., 3(2):12.

Riyadina, W., dan Rahajeng, E. 2013. Determinan penyakit stroke. Kesmas: National Public Health Journal, 7(7), 324-330.

Rossum, V,C.T., van de Mheen, H., Witteman, J. C., Hofman, A., Mackenbach, J. P., & Grobbee, D. E. 2000. Prevalence, treatment, and control of hypertension by sociodemographic factors among the Dutch elderly. Hypertension, 35(3), 814-821.

Saseen, J.J, and Maclaughlin, E.J. 2008. Hypertension. In: Dipiro, J.T., Talbert, R.L., Yee, G.C., Matzke, G.R., Wells, B.G., Posey, L.M., Pharmacotherapy A Pathopysiologic Approach. 7th edition. The McGraw-Hill Companies, Inc. p. 140-163.

Sedjatiningsih, W. 2013. Pengaruh pemberian obat antihipertensi terhadap penurunan tekanan darah pasien stroke iskemik akut yang menjalani rawat inap di RSUP DR. Sardjito Yogyakarta. Doctoral dissertation. Yogyakarta: Universitas Gadjah Mada.

Sacco, R. L., Kasner, S. E., Broderick, J. P., Caplan, L. R., Connors, J. J., Culebras, A., & Hoh, B. L. 2013. An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 44(7), 2064-2089.

Sumawa, PMR., Adeanne, CW., and Paulina, V.Y.Y. 2015, Evaluasi kerasionalan penggunaan obat antihipertensi pada pasien hipertensi rawat inap di RSUP Prof. Dr. R. D. Kandou Manado Periode Januari-Juni 2014. Sci., 4(3), 2302- 2493.

Tomiyama, H., and Yamashina, A., 2014, Beta-blockers in the management of hypertension and / or chronic kidney disease, Review article, 1-7.

Zhang. 2011. Clinical factors in patients with ischemic versus hemorraghic stroke in East China. World J Emerg Med 2(1):18-23.

DOI: 10.23917/pharmacon.v18i01.13230

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