ANALISIS PENGGUNAAN OBAT PADA KOMPLIKASI SIROSIS HATI

https://doi.org/10.22146/jmpf.270

Yeni Farida(1*), Tri Murti Andayani(2), Neneng Ratnasari(3)

(1) 
(2) 
(3) 
(*) Corresponding Author

Abstract


Penatalaksanaan terapi sirosis hati bervariasi sesuai dengan komplikasi yang menyertai. Penelitian ini bertujuan untuk mengetahui gambaran penggunaan obat pada komplikasi sirosis hati dan membandingkan kesesuaiannya dengan standar pelayanan medik rumah sakit dan guideline Asia Pasific Ascociation Study for Liver (APASL). Penelitian ini merupakan penelitian observasional analitik dengan pengambilan data secara retrospektif. Subyek penelitian diperoleh dengan teknik purposive sampling dengan kriteria inklusi pasien dewasa dan rawat inap pada periode 2013. Data diperoleh dari rekam medik kemudian dianalisis dengan cara membandingkan kesesuaian pemberian obat dengan standar pelayanan medik rumah sakit dan guideline APASL. Subyek penelitian berjumlah 70 pasien dengan komplikasi utama hipertensi portal (varises esofagus) sebanyak 46 kasus, perdarahan 24 kasus, ascites 36 kasus, infeksi 28 kasus dan ensefalopati hepatik 24 kasus. Terapi utama hipertensi portal dengan propranolol, perdarahan dengan vitamin K, ascites dengan spironolakton dengan atau tanpa kombinasi furosemid, infeksi dengan sefalosporin generasi 3 dan quinolone, ensefalopati hepatik dengan laktulosa dengan atau tanpa neomisin, BCAA dan LOLA. Hasil penelitian menunjukan bahwa penanganan komplikasi sirosis hati di RSUP Dr. Sardjito belum semuanya sesuai dengan standar pelayanan medik rumah sakit dan guideline APASL. Pada kondisi pasien yang tidak mengalami perbaikan dengan terapi standar dilakukan modifikasi terapi seperti pada kasus perdarahan dengan menambahkan proton pump inhibitor (omeprazole, lansoprazol atau pantoprazol) dan asam traneksamat.

 

Kata kunci: pengobatan sirosis hati, komplikasi sirosis hati, standar pelayanan medik rumah sakit,


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DOI: https://doi.org/10.22146/jmpf.270

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