Potensi Interaksi Obat di Ruang Rawat Intensif: Sebuah Studi Observasional di Salah Satu Rumah Sakit Kota Bandung
Abstract
Ruang rawat intensif atau Intensive Care Unit (ICU) rumah sakit berperan dalam menangani pasien yang membutuhkan penanganan intensif. Perlunya intervensi pasien yang komprehensif dan cepat berpotensi menyebabkan kejadian interaksi obat dengan obat yang dapat menyebabkan reaksi obat yang tidak dikehendaki. Penelitian ini bertujuan untuk mendeskripsikan potensi kejadian interaksi antara obat dengan obat yang digunakan di ruang ICU salah satu rumah sakit di Kota Bandung. Studi observasional deskriptif ini dilakukan di salah satu rumah sakit Kota Bandung pada bulan Maret 2021. Penggunaan obat di ruang ICU diamati melalui laporan penggunaan obat ruang ICU rumah sakit dan potensi kejadian interaksi obat dengan obat diidentifikasi melalui instrumen software drug interaction checker. Proses validasi dilakukan dengan menganalisis hasil interaksi dengan literatur interaksi obat dan instrumen drug interaction checker lainnya. Terdapat 21 jenis obat yang paling sering digunakan di lokasi penelitian. Analisis dengan menggunakan instrumen dan literatur interaksi obat menunjukkan terdapat 22 pasangan interaksi obat dengan obat yang berpotensi terjadi. Interaksi obat tersebut meliputi tiga interaksi obat dengan tingkat keparahan mayor, yaitu interaksi obat deksametason-levofloksasin; fenitoin-nikardipin; fenitoin-nimodipin, sedangkan sisanya merupakan interaksi obat dengan tingkat keparahan moderat. Potensi interaksi obat dengan obat yang terjadi umumnya berdampak pada tekanan darah dan sistem saraf. Tingginya potensi kejadian interaksi obat dengan obat perlu menjadi perhatian bagi para tenaga kesehatan dalam pemilihan obat di ICU. Studi lanjutan diperlukan untuk menganalisis potensi penggunaan obat lainnya yang dapat menekan efek interaksi obat sehingga diharapkan dapat mencegah terjadinya reaksi obat yang tidak dikehendaki di ICU.
Kata kunci: Drug related problems, ICU, interaksi obat-obat
Potential Drug-Drug Interaction in the Intensive Care Unit: An Observational Study at a Hospital in Bandung
Abstract
The hospital’s Intensive Care Unit (ICU) is at the forefront of treating emergency patients requiring intensive care. The comprehensive, fast, and accurate medication in the unit causes the incidence of drug-drug interactions (DDI’s) and can lead to therapeutic failures in patients. Therefore, this study aimed to describe potential (DDIs) in the ICU of a hospital in Bandung. A descriptive observational study was performed in a hospital in Bandung from 1st to 31st March 2021. The drug use report observed the use of medics in the ICU. Furthermore, the potential DDI’s were identified using a drug interaction checker. It was validated using the textbook and another reputable checker. There are twenty-one types of drugs commonly used in the study setting, and the analysis showed twenty-two potential DDI’s. The interaction consists of three significant DDI’s, including dexamethasone-levofloxacin, phenytoin-nicardipine, and phenytoin-nimodipine, while the others are moderate. The majority of them generally affect the blood pressure and nervous system. Health care providers should observe the high incidence of DDI’s when selecting and monitoring drugs in the ICU. Further study is needed to explore the potential of other drugs that can minimize the interaction effect. Therefore, it is expected to improve ICU patients’ safety in adverse drug reaction situations.
Keywords: Drug-drug interactions, drug-related problems, ICU
Keywords
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DOI: https://doi.org/10.15416/ijcp.2022.11.1.41
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